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PubMed2006

[Disability in lupus erythematosus].

Morbidity and co-morbidities in patients with lupus erythematosus (LE) result in an impairment, limiting activities of daily living. We compared the handicap, appraised by the German welfare system in patients with LE and their diagnosis, morbidities and co-morbidities, therapy, functional capacity, psychological status and general health. The data were obtained in an anonymous self-administered questionnaire conducted by the lupus patient association. 892 data sets were available for the trial. The mean age was 46.9y, disease duration was 10.3y. The patients had 3.8 concomitant diseases on average. 39.7% were still working and 35.4% drew a pension. 59.2% made an application for disability, which wasn't assigned in only 2.5% of cases. 82.6% had an average grade of disability of more than 50%. It demonstrated a good correlation to age, disease duration, type of LE and therapy. Predictors for a worse assessment were disease duration, osteoarthritis, cerebral insults and functional capacity. In conclusion the data demonstrate a fair appraisal of disability by the German welfare system in patients with LE. Self-administered questionaires can yield credible results.

Disability Evaluation↗
PubMed1993

Medical school policies regarding medical students and HIV infection.

PURPOSE: To ascertain how medical schools address several difficult policy issues regarding medical students and HIV (human immunodeficiency virus), and to examine whether schools' policies differ according to the incidences of HIV in the schools' locations. METHOD: Between January 5, 1990, and March 20, 1991, 15-minute telephone interviews were conducted with spokespersons (deans or other policymakers) at 42 U.S. medical schools: the 14 in areas of high incidence of HIV, the ten in areas of low incidence, and a convenience sample of 18 in areas of medium incidence. The interview questions were about preventing HIV infection, reporting HIV infection, confidentiality, screening for HIV infection, limiting clinical activities, counseling, hepatitis B vaccination, prophylactic zidovudine administration, and disability and health insurance. RESULTS: A total of 16 schools, including seven of the 14 in high-incidence areas, had no policy regarding medical students with HIV infection. No strong statistically significant difference was found between the responses of schools in low-incidence areas and those of schools in high-incidence areas. No medical school routinely tested its students for HIV. CONCLUSIONS: Schools should do more to ensure that students remember and follow the guidelines about preventing occupational exposure to HIV; in addition, prior to screening for HIV, schools should ensure that students are provided with appropriate levels of health, life, and disability insurance.

AIDS Serodiagnosis↗
PubMed2006

Disability pension among immigrants in Sweden.

Using large samples, disability pensions among foreign-born and native-born women and men living in Sweden is studied here for the period 1981-1999. The results show foreign-born individuals having higher rates of disability pension. The risk of being on disability pension is very low for newly arrived immigrants, but increases rapidly on a yearly basis after immigration. Higher rates of disability pension are reported for persons born in Greece, Yugoslavia, Turkey and Finland. Results from multivariate analysis indicate that factors such as education, country of residence and marital status cannot fully explain the high rates of disability pension observed among many immigrant groups. Future research needs to address which possible causes are most important for policies to address.

Persons with Disabilities↗
PubMed2004

[Costs of early retirement--the case of schizophrenia].

Schizophrenia is a severe psychic disorder that occurs at young age and often leads to a work disability. The disease not only induces direct costs in the health care system but also indirect costs that show up in the social security system. In this study, we apply statistics from the social security administration on early retirement due to disability. Over 6000-males and females per year retire with the diagnosis schizophrenia (classified as 295, ICD-9). The average retirement age is 39 for males and 42 for females. Schizophrenia is the most important single reason for early retirement before age 40. Of all male cases of disability retirement under the age of 40, 14.7 % are due to schizophrenia. The present discounted value of pensions paid out before the standard retirement age of 65 is 215 000 Euro for an average male. Moreover, the revenue loss in income taxes and payroll contributions amounts to 345 000 Euro. In the year 2000, a total of 125 000 persons under the age of 65, who originally entered retirement with the diagnosis schizophrenia, are estimated to be receiving a pension. The corresponding annual expenditures of the social security system reach 1.3 Billion Euro; the revenue loss (pay-roll plus income taxes) reaches 2 Billion Euro. Since only two thirds of the working age population is covered by the social security system, the costs of early retirement due to schizophrenia are underestimated by a factor of at least one third.

Adult↗
PubMed2004

Outcomes of managing disability benefits among patients with substance dependence and severe mental illness.

To evaluate the feasibility and efficacy of a program to manage Social Security disability benefits in a clinical sample of patients with severe mental illness and co-occurring substance dependence, 41 patients were randomly assigned to have their benefits either contingently or noncontingently managed through their mental health center. Contingent management involved adjustments to the type or frequency (not amount) of disability benefits and payments for study participation based on ratings of substance use, money management, and treatment follow-through. The patients with contingent management used significantly less alcohol and drugs and showed much better money management than those with noncontingent management. Patients and case managers who participated in the study reported that they found the management strategy to be acceptable and useful.

Adult↗
PubMed1997

Attacking the disability and absenteeism epidemic--behavioral health care solutions.

To remain competitive in a global economy, employers must implement effective programs to stem escalating disability claims and increased costly absenteeism. This article discusses methods to counter this latest workforce epidemic. The authors discuss employee attitudes, legal considerations and behavioral health care solutions.

Absenteeism↗
PubMed1997

Managing disabilities in an integrated health environment: the experience of Aetna.

Disability-related outlays are increasing at a rate well above the medical inflation rate. This article discusses the experience of one company in its attempt to manage these skyrocketing costs, by developing a new program that integrates health and related benefits by combining the medical and human resources interventions into a unified program. The authors discuss the initiation, development and progress of the program, concluding with measured results revealing reduced lost work time, improved employee health and productivity, and reduced disability costs.

Cost Control↗