Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Insurance, Disability”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed1996

Medicaid eligibility policies for people with AIDS.

Although Medicaid is the primary payer for health services provided to people with AIDS, Medicaid eligibility policies can be restrictive. This study presents Medicaid eligibility policies in each state for people with AIDS or HIV infection, including the categorical and medically needy classifications. The study documents that medically needy coverage is an important route to Medicaid coverage for people with AIDS. Because of the importance of this medically needy coverage, extending presumptive disability to any person with HIV and allowing them to spend down would provide a health financing safety net for people infected with HIV.

Acquired Immunodeficiency Syndrome↗
PubMed2001

The development and evaluation of the brief depression screen in medically ill disability claimants.

OBJECTIVE: There is literature demonstrating elevated prevalence of depression in primary care. Yet there remains a need for a brief depression screen designed and evaluated specifically for use among medically ill patients. Our objective was to develop and validate a brief, unobtrusive screen for depression among severely medically ill long-term disability claimants. METHODS: The study sample consisted of 480 long-term disability claimants, less than 55 years of age, with one of the following illnesses: cancer, diabetes, myocardial infarction, rheumatoid arthritis, stroke, or multiple sclerosis. Each subject completed a questionnaire that included 26 potential screening items. A subset of subjects was administered the SCID, which served as the gold standard for the DSM-IV depression and dysthymia diagnoses. RESULTS: The Brief Depression Screen, a three-item screen for major depressive disorder and dysthymia, was developed. About 34 percent of the sample met criteria for major depressive disorder or dysthymia. The Brief Depression Screen detected 75 percent of those subjects in this sample. Furthermore, nearly half of the subjects with positive screen results met criteria for depression or dysthymia. These results are comparable to those of the eight-item Burnam screen, but not as sensitive as the more widely used, twenty item CES-D. CONCLUSION: The Brief Depression Screen was developed and evaluated for use with severely ill long-term disability claimants. In practice, a positive screen for depression is to be followed with a comprehensive diagnostic assessment that could be conducted by a trained clinician. Further research is warranted to determine whether the identification and treatment of depression in disability claimants with non-psychiatric medical illnesses will facilitate return to work, even in the presence of comorbid medical illnesses.

Depressive Disorder↗
PubMed2003

Primary care satisfaction among adults with physical disabilities: the role of patient-provider communication.

OBJECTIVES: To determine overall satisfaction with primary care among people with cerebral palsy, multiple sclerosis, and spinal cord injury, and to identify potential differences in primary care satisfaction between managed care (MC) and fee-for-service (FFS) enrollees with these physical disabilities. PARTICIPANTS: The sample consisted of 195 people with cerebral palsy (CP), multiple sclerosis (MS), and spinal cord injury (SCI), between the ages of 18 and 65 who had received primary care services in the six months prior to the survey. MEASUREMENTS: Satisfaction with various aspects of primary care were assessed using a 10-item self-report measure. Respondents were compared with regard to service satisfaction based on disability and insurance type (MC vs. FFS). Satisfaction items were summed up to produce an unweighted index of overall satisfaction. In the analysis we used non-parametric statistics, such as Kruskal-Wallis One Way ANOVA and Mann-Whitney Rank tests. Post hoc alpha corrections were performed using the Holms Stepdown Procedure. CONCLUSIONS: The lack of disability-specific knowledge among primary care providers is consistent with findings of other studies. People with physical disabilities in managed care plans are less satisfied with how their providers communicate with them, relative to those in FFS plans. Poor patient-provider communication may place individuals with certain physical disabilities at risk for not receiving appropriate care.

Adolescent↗
PubMed2004

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 9. Consequences of being on sick leave.

The possible consequences of sick leave can be measured at different levels in society. This chapter focuses on the consequences from the perspective of the sick-listed individual. Sick leave may have both positive and negative consequences for the individual, e.g. regarding disease, health, working life, social life, lifestyle, and emotional aspects. Some of these factors have been investigated in different studies. However, scientific evidence is insufficient since there are too few studies on the consequences of sickness absence and disability pension. The lack of relevant studies is the most striking observation from the review of studies on the consequences of being sick listed.

Absenteeism↗
PubMed2001

Employee Retirement Income Security Act of 1974; rules and regulations for administration and enforcement; claims procedure. Final regulation; delay of applicability date.

This action delays for at least six months and not more than one year the applicability date for the regulation governing minimum requirements for benefit claims procedures of group health plans covered by Title I of the Employee Retirement Income Security Act. As published on November 21, 2000, the benefit claims procedure would be applicable to claims filed on or after January 1, 2002. The current action amends the regulation so that it will apply to group health claims filed on or after the first day of the first plan year beginning on or after July 1, 2002, but in no event later than January 1, 2003. This action provides a limited additional period within which group health plan sponsors, administrators, and service providers can bring their claims processing systems into compliance with the new requirements. A postponement of the applicability date with respect to group health claims will allow a more orderly transition to the new standards and will avoid the confusion and additional expense that would be caused if certain pending Congressional bills are enacted before or soon after the original applicability date. This action does not apply to pension plans or plans providing disability or welfare benefits (other than group health). For these plans, the regulation will continue to be applicable to claims filed on or after January 1, 2002.

Employee Retirement Income Security Act↗
PubMed2003

Disabler: a game occupational health nurses cannot afford to play.

The dynamics of the Disabler game are complex, not always recognizable, and less than easily manageable. Awareness of the game and a willingness to avoid direct participation can enhance injured worker rehabilitation and decrease costs associated with lost time and productivity. Not playing the Disabler game can make the role of the occupational health nurse more rewarding. The game requires the field upon which to play, and effectively supported DMPs can help eliminate those playing fields.

Case Management↗
PubMed2006

Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population.

BACKGROUND: Neck and low back pain are common musculoskeletal complaints generating large societal costs in Western populations. In this study we evaluate the magnitude of long-term health outcomes for neck and low back pain, taking possible confounders into account. METHOD: A cohort of 2,351 Swedish male farmers and rural non-farmers (40-60 years old) was established in 1989. In the first survey, conducted in 1990-91, 1,782 men participated. A 12-year follow-up survey was made in 2002-03 and 1,405 men participated at both times. After exclusion of 58 individuals reporting a specific back diagnosis in 1990-91, the study cohort encompassed 1,347 men. The health outcomes primary care consultation, hospital admission, sick leave and disability pension were assessed in structured interviews in 2002-03 (survey 2). Symptoms and potential confounders were assessed at survey 1, with the exception of rating of depression and anxiety, which was assessed at survey 2. Multiple logistic regression generating odds ratios (OR) with 95% confidence intervals (95% CI) was performed to adjust the associations between reported symptoms and health outcomes for potential confounders (age, farming, workload, education, demand and control at work, body mass index, smoking, snuff use, alcohol consumption, psychiatric symptoms and specific back diagnoses during follow up). RESULTS: Of the 836 men reporting current neck and/or low back pain at survey 1, 21% had had at least one primary care consultation for neck or low back problems, 7% had been on sick leave and 4% had disability pension owing to the condition during the 12 year follow up. Current neck and/or low back pain at survey 1 predicted primary care consultations (OR = 4.10, 95% CI 2.24-7.49) and sick leave (OR = 3.22, 95% CI 1.13-9.22) after potential confounders were considered. Lower education and more psychiatric symptoms were independently related to sick leave. Lower education and snuff use independently predicted disability pension. CONCLUSION: Few individuals with neck or low back pain were on sick leave or were granted a disability pension owing to neck or low back problems during 12 years of follow up. Symptoms at baseline independently predicted health outcomes. Educational level and symptoms of depression/anxiety were important modifiers.

Adult↗
PubMed1999

Medical cost for disability: a longitudinal observation of national health insurance beneficiaries in Japan.

OBJECTIVES: To measure the impact of disability on the use of medical care and its costs. DESIGN: A 1-year prospective cohort study of National Health Insurance beneficiaries in a rural Japanese community. Their physical function was examined by the Medical Outcomes Study questionnaire at the end of 1994; medical care and its costs were then monitored for 1 year. SETTING AND PARTICIPANTS: Participants were the 49,364 subjects, aged 40 to 79 years, who were beneficiaries of National Health Insurance and lived in the catchment area of Ohsaki Public Health Center, Miyagi, Japan. The subjects were mainly farmers, self-employed persons, housewives, or pensioners. MEASUREMENTS: Medical care utilization (number of outpatient visits and days of inpatient care) and the costs for each subject were obtained from National Health Insurance Claim History files. These measurements were collected from January to December 1995, and the relationship between physical functioning levels and medical costs was analyzed. RESULTS: The medical costs per capita increased with poorer physical function. Medical costs among those with limitations in performing self-care increased by 4 times in men and 3 times in women compared with those with no functional limitation. In this cohort, the 4.3% of the subjects who were dependent in self-care used 15% of the total inpatient days and 10% of the total medical costs. CONCLUSION: Treatment of patients with disability requires a huge amount of medical resources. There is an urgent need for cost-effective intervention programs for disability prevention, which could be offset against the cost for treating the disabled.

Activities of Daily Living↗
PubMed1997

Symptom overreporting in combat veterans evaluated for PTSD: differentiation on the basis of compensation seeking status.

We examined the role of compensation-seeking status on response patterns to self-report inventories of acute psychopathology and psychological distress in a group of 165 combat veterans evaluated for posttraumatic stress disorder (PTSD) at a Department of Veteran Affairs (VA) Medical Center. Veterans completed the Minnesota Multiphasic Personality Inventory-Revised, Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, a fixed-response format version of the Dissociative Experiences Scale, and Impact of Events Scale as part of a standard assessment battery. Results showed that compensation-seeking veterans endorsed dramatically higher levels of psychopathology across measures and produced sharply elevated "fake-bad" validity indices as compared to non-compensation-seeking veterans. Differences between the two groups on most scales and indices exceeded effect sizes of 1.0, even when effects of income, global assessment of functioning, and clinician-rated severity of PTSD were controlled for. It is suggested that the availability of VA disability compensation for combat-related PTSD impedes accurate initial assessment of veterans presenting for treatment and may impair estimation of long-term therapeutic outcome in this population.

Bias↗
PubMed1997

High demand, low-control jobs reduce productivity and increase workplace disability costs.

Workplace behavioral risk management methods build on EAP core technologies to help employers improve productivity and reduce direct and indirect costs of behavioral conditions. Current research suggests that restructuring high-demand, low-control jobs may enhance productivity and reduce disability costs. The author suggests that the use of appropriate social supports and coping-skills training will further offset the damaging consequences of high-demand, low-control jobs.

Adaptation, Psychological↗
PubMed2002

Mortality in relation to early retirement in Denmark: a population-based study.

AIMS: The aim of this study was to examine whether early retirement is gained by persons with poor health or whether retirement leads to negative changes in health. Mortality for persons in Denmark using one of two publicly financed retirement schemes was investigated. Disability benefit (førtidspension) was granted for health reasons mainly, while early retirement benefit (efterløn) was earned through long-term membership of an unemployment benefit scheme. METHODS: Data from Danish population-based registers were used for each year in the period 1986-96. The study setting was the population of Denmark, born between 1926 and 1936. RESULTS: the standardized mortality ratio in employed persons was low (0.59 and 0.51 for men and women, respectively) and high in disability benefit recipients (2.31 and 1.66). The mortality in the early retirement benefit recipients (0.88 and 0.72) was in between the mortality for the disability benefit recipients and the employed persons. Disability benefit recipients had a high relative risk of death immediately after retirement. In early retirement recipients the relative risk of death increased with time since retirement. CONCLUSIONS: Disability benefit was mainly gained by persons with poor health. In contrast, the increasing mortality of the early retirement recipients is consistent with an adverse effect on health of retirement itself, but may also be due to the cessation of health selection in the group of disability benefit recipients after retirement. It is difficult to disentangle the effects of a change in activity following retirement from the effects of an earlier health-associated selection into the two retirement schemes.

Aged↗
PubMed2005

[Assessment, treatment and counselling of patients claiming sick leave and disability: recommendation from the Health Council].

As requested by the Minister for Social Services and Employment, the Health Council of The Netherlands reviewed existing medical guidelines on the assessment, treatment and counselling of patients claiming sick leave and disability. These guidelines were developed separately by physicians concerned with their own specific fields. The Health Council recommends the development of more encompassing guidelines, based on scientific evidence whenever possible, starting with 10 diagnoses that frequently lead to long-term industrial disability. The assessment of long-term disability is complex and varies for each individual. The contribution of scientific 'evidence' remains modest. It is not possible to predict permanent disability with lists of diseases and corresponding medical prognoses. It may be possible to support the assessment by 'mediprudence', cases of example. The recommendation of the Health Council offers perspective toward qualitatively improved assessment of the effects of diseases on patient functioning.

Absenteeism↗
PubMed2006

Barriers to employment for people with schizophrenia.

OBJECTIVE: There is growing interest in identifying and surmounting barriers to employment for people with schizophrenia. The authors examined factors associated with participation in competitive employment or other vocational activities in a large group of patients with schizophrenia who participated in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, a multisite clinical trial comparing the effects of first- and second-generation antipsychotics. METHOD: Baseline data on more than 1,400 patients with a diagnosis of schizophrenia were collected before their entry into the CATIE study. Multinomial logistic regression was used to examine the relationship between participation in either competitive employment or other vocational activities and sociodemographic characteristics, schizophrenia symptoms, neurocognitive functioning, intrapsychic functioning, availability of psychosocial rehabilitation services, and local unemployment rates. RESULTS: Altogether, 14.5% of the patients reported participating in competitive employment in the month before the baseline assessment, 12.6% reported other (noncompetitive) employment activity, and 72.9% reported no employment activity. Participation in either competitive or noncompetitive employment was associated with having less severe symptoms, better neurocognitive functioning, and higher scores on a measure of intrapsychic functioning that encompassed motivation, empathy, and other psychological characteristics. Competitive employment, in contrast to other employment or no employment, was negatively associated with receipt of disability payments as well as with being black. Greater access to rehabilitation services was associated with greater participation in both competitive and noncompetitive employment. CONCLUSIONS: Overall employment of persons with schizophrenia seems to be impeded by clinical problems, including symptoms of schizophrenia and poorer neurocognitive and intrapsychic functioning. However, participation in competitive employment may be specifically impeded by the potentially adverse incentives of disability payments and by race and may be promoted by the availability of rehabilitation services.

Adult↗
PubMed2001

Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research.

BACKGROUND: The purpose of this review was to identify critical data and research needs in addressing the following question: What are the primary factors that affect the time lost from work, return-to-work (RTW), subsequent unemployment, and changes in occupation after disabling illness or injury? METHODS: Review of the literature to identify research challenges originating from the multitude of disciplines, data sources, outcome measures, and methodological and analytical problems. RESULTS: About 100 different determinants of RTW outcomes were identified. Their impact varies across different phases of the disablement process. Recommendations are provided for addressing five selected research challenges. CONCLUSION: Interdisciplinary research needs to develop a comprehensive conceptual framework. Priority should be given to studies on specific domains of risk factors meeting five selection criteria: amenability to change; relevance to users of research; generalizability across health conditions, disability phases, and settings; "degree of promise" as derived from qualitative exploratory studies; and capacity to improve measurement instruments. Combining qualitative and quantitative research methods is necessary to bridge existing knowledge gaps.

Accidents, Occupational↗