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PubMedDate not supplied

The need for a national strategy for chronic pain management in Ireland.

BACKGROUND: Chronic pain is defined as pain on a daily basis for more than six months. It affects 13% of the Irish population. Despite its prevalence and the impact on patient's quality of life there is no national strategy for this problem. AIM: To determine the need for a national strategy for chronic pain in Ireland. METHODS: The cost of low back pain (LBP) (common chronic pain condition), the level of education and research and current chronic pain clinic resources were investigated. RESULTS: The cost of LBP in Ireland is enormous: disability payments from the Department of Social and Family Affairs amounted to euros 348 million and insurance payments cost euros 10.5 million. The number of teaching hours timetabled for pain education in the schools of Medicine, Physiotherapy, Dentistry, Nursing and Psychology in Ireland's six universities varied significantly (e.g. 11.5-72 hrs in nursing). Research grants awarded from state organisations were limited to one over a four-year period. No current chronic pain clinics comply with recommended International Association for the Study of Pain (IASP) guidelines. CONCLUSION: A national strategy is needed to reduce costs, standardise teaching and increase pain clinic resources to maximise patient care.

Chronic Disease↗
PubMed2002

Disability and medical management of natural latex sensitivity claims.

In 1995 a latex allergy case incurred a cost of $220,000 within the first year of the claim. A number of factors were thought to contribute to the cost of these claims. In 1996 Michigan Health & Hospital Association Service Corporation identified and implemented protocols to intervene early with latex sensitivity claims. The average cost per case has decreased dramatically since the implementation of the protocols. Decreasing the frequency and the average cost of latex sensitivity claims through the identification, treatment, and return to work of legitimate latex sensitivity cases has been the focus. Equally important was to minimize the impact of latex sensitivity on the life of the health care worker. In 1999 and subsequent years, data from glove- or latex-related claims that began from 1996 were analyzed. Latex sensitivity-related claims were sorted as lost-time claims and medical-only claims from the Michigan Health & Hospital Association Service Corporation claims database. The average cost per claim and the frequency of latex-related claims were identified. The average cost of latex-related lost-time claims has decreased significantly; however, the frequency in lost-time claims has been consistent. Health care workers consistently were returned to work successfully. Implementation of latex-sensitivity protocols is effective in the reduction of the average cost of latex-related claims and the impact of those claims on the lives of health care workers. This has been afforded through the confirmation of the diagnosis of latex sensitivity, followed by the implementation of a method to evaluate the physiologic response to the workplace objectively.

Costs and Cost Analysis↗
PubMed2006

The prognosis for individuals on disability retirement. An 18-year mortality follow-up study of 6887 men and women sampled from the general population.

BACKGROUND: Several studies have shown a markedly higher mortality rate among disability pensioners than among non-retired. Since most disability pensions are granted because of non-fatal diseases the reason for the increased mortality therefore remains largely unknown. The aim of this study was to evaluate potential explanatory factors. METHODS: Data from five longitudinal cohort studies in Sweden, including 6,887 men and women less than 65 years old at baseline were linked to disability pension data, hospital admission data, and mortality data from 1971 until 2001. Mortality odds ratios were analyzed with Poisson regression and Cox's proportional hazards regression models. RESULTS: 1,683 (24.4%) subjects had a disability pension at baseline or received one during follow up. 525 (7.6%) subjects died during follow up. The subjects on disability pension had a higher mortality rate than the non-retired, the hazards ratio (HR) being 2.78 (95%CI 2.08-3.71) among women and 3.43 (95%CI 2.61-4.51) among men. HR was highest among individuals granted a disability pension at young ages (HR >7), and declined parallel to age at which the disability pension was granted. The higher mortality rate among the retired subjects was not explained by disability pension cause or underlying disease or differences in age, marital status, educational level, smoking habits or drug abuse. There was no significant association between reason for disability pension and cause of death. CONCLUSION: Subjects with a disability pension had increased mortality rates as compared with non-retired subjects, only modestly affected by adjustments for psycho-socio-economic factors, underlying disease, etcetera. It is unlikely that these factors were the causes of the unfavorable outcome. Other factors must be at work.

Adult↗
PubMed1995

The future of disability management is ... integration.

The synergy that results from the integration of disability and health care innovations can significantly improve both productivity and profitability, recent experience shows. Such integration also links employees and employers in a way that achieves continuous improvement of work life, further enhancing individual and corporate performance.

Cost of Illness↗
PubMed2001

[Utilization of health care system by patients with chronic pain who apply for disability pensions. A registry study].

INTRODUCTION: Patients with chronic pain may be awarded a disability pension if their working capacity is reduced as a result of an illness. Patients with chronic pain very often consult several specialists in order to obtain proof of their illness. The aim of this study was to investigate how an application for disability pension affected the utilization of health care services by patients with chronic pain. METHOD: Patients with chronic pain who applied for a disability pension in 1989 and 1990 were entered. The study period was divided into three: the year preceding the submission of the application for a disability pension, the time from submission of the application to the making of the decision, and the year following the decision of the health authorities. The patients were divided into four subgroups according to whether the disability pension was awarded or rejected, and whether the patients accepted or appealed the decision. The total costs of care in the primary sector were calculated on the number of and charges for visits to GPs and the total costs of hospital care were calculated on the number of bed days, visits to outpatients clinics, operations, and investigations. RESULTS: Patients with chronic pain had a significantly lower health care utilisation after the case has been closed. Those who did not get a disability pension and those who were not satisfied with the level of the disability pension, continued their utilisation of health care after the decision. The mean health care used by patients who appealed the level of the disability pension was three times higher than that used by patients who accepted the level of the disability pension. CONCLUSION: The study indicates that lack of or insufficient economic compensation from the social system in patients with chronic pain may contribute to inexpedient behaviour leading to increased costs to the health care sector.

Chronic Disease↗
PubMedDate not supplied

Staying afloat.

Explore the source record for details and available documents.

Persons with Disabilities↗
PubMed2002

[Dentist and disability: a matter of occupational disease?].

The incidence of and background to disability claims by dentists relating to 1999 are presented on the basis of data from Movir insurance company. Possible cases of occupational related disease are indicated. Claims resulting in more than 2 weeks sick leave have been received from almost 7% of the insured dentists (excluding pregnancy related sick leave). In nearly 30% of the cases, sick leave lasted for more than 1 year (particularly due to mental and musculoskeletal disorders). Compared to the figures for 1992 long-term health related absenteeism (longer than 365 days) has increased by as much as 155%. It is estimated that at least 15% of the claims are occupationally related. Based on the 1999 data a dentist would have approximately a chance of 50% for partial or complete premature retirement due to ill health.

Dentists↗
PubMed2002

Integrating measurements of disability in federal surveys: seminar proceedings. Documents and Committee Reports.

In November 2000, the Federal Committee on Statistical Methodology (FCSM) convened the seminar "Integrating Federal Statistical Information and Practices" to foster a great awareness of the importance of integrating statistical information issued by different Federal agencies. Disability statistics was one of a dozon cross-cutting subject matter areas that were discussed at the FCSM seminar. This publication contains the proceedings of the session on "Integrating Comparable Measures of Disability in Federal Surveys." The first part of this publication describes programs that count people with disabilities in surveys of four Federal statistical agencies: the Bureau of Labor Statistics, the Social Security Administraion, the National Center for Health Statistics, and the Bureau of Justice Statistics. The second part of this publication contains the remarks of the sessions' two discussants. The recognize thesignificant progress made by th four Federal agencies in developing survey disability measures responsive to their own agency needs but conclude that by mandate or purpose of the data collection, the disability measures differ significantly between agencies and interagency integration of disability statistics will be difficult. The discussants propose research and funding strategies to improve disability measurement integration among Federal statistical agencies.

Activities of Daily Living↗
PubMed2003

[Utilization of occupational ability by persons on early retirement. A registry study].

INTRODUCTION: Danish social legislation operates with three levels of disablement pension: the highest level is given when the ability to work is lost; the middle level is given when the ability is estimated to be diminished to one third of the capacity of a healthy person; and the lowest pension is given when this ability is estimated to be half that of a healthy person. Many disabled persons would therefore be expected to work to supplement their pensions. MATERIAL AND METHODS: In 1997, 17,196 persons, who obtained a disablement pension in 1995, were asked via Statistics Denmark about their occupational income. The population was grouped according to income, sex, age, marital status, education, and the level of the pension. RESULTS: Of these, 81.1% earned nothing at all (< 1 krone), and only 5% earned > 50,000 kroner. The odds ratios for having an income to supplement the pension were: highest and middle pension/lowest pension 1.09, men/women 1.66, age below 40/above 40 years 1.50, living together/alone 1.31, and education/no education 1.46. DISCUSSION: Disabled, early retired persons are not making use of their theoretical ability to supplement their disablement pension with paid work, and the estimates of ability to work are not closely associated with the level of the disablement pension. Those who have jobs to supplement their pensions are significantly more likely to be men, younger rather than older, and educated rather than uneducated.

Adult↗
PubMed2004

[Chronic musculoskeletal pain--aspects for assessment in private disability compensation (I)].

Pain is the most frequent symptom of diseases of the musculoskeletal system. Moreover pain is the most frequent complaint in applications for governmental or private disability compensation. Since pain remains a subjective sensory perception, it is the task of assessment to prove all the proband's information for consistency. Both multidimensionality of chronic pain and a high impact of psychosomatic comorbidity imply that not only orthopaedic and traumatologic but as well psychosomatic competence for legal assessment is required.

Chronic Disease↗
PubMed2005

Revised medical criteria for evaluating genitourinary impairments. Final rules.

We are revising the criteria in the Listing of Impairments (the listings) that we use to evaluate claims involving genitourinary impairments. We apply these criteria when you claim benefits based on disability under title II and title XVI of the Social Security Act (the Act). The revisions reflect advances in medical knowledge, treatment, and methods of evaluating genitourinary impairments.

Adult↗
PubMed1997

Disability payments continue to climb. "Tell us what you see, not what you think," CPP tells MDs.

Growing concern about the sustainability of the Canada Pension Plan has led to a closer look at the disability benefits it provides. The federal auditor general reported recently that the number of recipients has almost doubled in the past 10 years, and disability payments have more than tripled, to $3 billion annually. This article looks at the role physicians play in determining whether an applicant is disabled.

Canada↗