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 1,351 records · Page 75Linked to original sources
PubMed1998

Health care and indemnity costs across the natural history of disability in occupational low back pain.

STUDY DESIGN: The administrative database maintained by the National Council on Compensation Insurance (United States) was used to compare health care use and indemnity costs within the natural history of work-related low back pain disability. OBJECTIVES: To determine the relative costs of health care services and indemnity at different phases of work disability. SUMMARY OF BACKGROUND DATA: Existing studies have compared total costs along the work disability continuum. This study replicates and extends these earlier studies by providing detailed evaluations of costs by service categories along this continuum. METHODS: Total health care and indemnity costs accrued along the disability curve were examined. Based on the number of days workers were absent from work and receiving indemnity payments (disability days), detailed mean health care costs by type of medial service were computed and compared across four time intervals for the sample. RESULTS: Health care costs were disproportionately distributed along the disability curve, with 20% of claimants disabled 4 months or more, accounting for 60% of health care costs. The most costly service category was diagnostic procedures (25% of total medical costs), with surgical costs (21%) and physical therapy (20%) representing the next two most costly categories. Mental health and chiropractic care represented a small percentage of overall costs (0.4% and 2.9%, respectively). CONCLUSIONS: These data provide policy-makers, program development, and health care industry groups with cost information from which to establish benchmarks for future decisions that facilitate the allocation of resources for more cost-effective management and prevention of work disability.

Absenteeism↗
PubMed2000

[The ICD-10 and the Unified Diagnoses Code of the Pension Insurance. Guidelines for interpretation of the diagnostic codes within the legislative framework for pension insurance].

The "International Statistical Classification of Diseases and Related Health Problems", Tenth Revision (ICD-10), has to be used by all social security funds in Germany since Jan. 1, 2000. For purposes of the official statistical classification of causes of death, it has been used since 1998. There are a number of fundamental differences between the ICD-10 and the ninth revision. In particular, a considerably higher degree of specification and differentiation warrant a thorough look at the ICD-10 in numerous respects. The Unified diagnoses code of the statutory pension insurance is an extract from the ICD-10 referring specifically to diseases occurring in medical rehabilitation and early retirement contexts. Several new four- and five-digit codes were added for statutory pension insurance purposes, hence are not contained in the original ICD-10. This extract will only turn out a practical tool if the physician is well-qualified in his particular field and is familiar with the sometimes very complex differentiations within the systematical register in volume I of the ICD-10. The article provides an overview of the structure of the ICD-10; deals with major novelties and alterations as well as practical problems; uses various exemplary diagnoses to illustrate a systematical approach in possibly problematical encoding; and recalls several general rules for diagnoses encoding in social medicine.

Chronic Disease↗
PubMed1994

[Use of disability pensions. Disability pensions from 1967 to 1992 in a group from Bergen born in 1940].

The authors describe the medical conditions (expressed by ICD-codes) leading to a disability pension in a cohort of 1,570 persons born in the year 1940. Information on disability pensions was extracted from the files of the National Insurance Administration for the years 1967-92. The disability diagnoses varied during the period 1967-92. Diagnoses during the first years reflect conditions that caused disability of young persons. Later on, diagnoses of "traditional" mental and organic diseases were used. Gradually other diagnoses, including alcoholism also appeared. This was a consequence of a broadening in the 1970s of the medical criteria for occupational disability. In recent years, disability diagnoses related to unspecific conditions are seen, particularly diagnoses reflecting symptoms associated with the musculosceletal system. These disability diagnoses were used in the case of about 30% of the women in the cohort who became new pensioners during the period 1988-92.

Cohort Studies↗
PubMed2006

High incidence of disability pension with a psychiatric diagnosis in western Sweden. A population-based study from 1980 to 1998.

Regional differences in Sweden in the prevalence of disability pension with a psychiatric diagnosis are unexplained, in spite of the significant impact on the population's health, rehabilitation systems, and the health care system. The purpose of this study was to describe the pattern of disability pensions with a psychiatric diagnosis and to analyze the impact of age and gender. We examined the incidence rates in one urban and one semi-rural region and compared these to national rates. The study sample was drawn from employed persons between 16-64 years of age who, because of their sickness insurance coverage, would be eligible to access disability pensions should it be necessary. Analysis of annual incidences and standardized morbidity ratios were made for 1980, 1985, 1990, 1995, and 1998. Data on disability pension cases were collected from the National Social Insurance registers. In the urban region we found that the proportion of men and women clearly outnumbered the national average: approximately twice the number of persons between 16-64 years of age with a psychiatric diagnosis were receiving a disability pension. In the semi-rural region there were fewer men overall on disability pensions with psychiatric disorders, but in 1980, 1985, and 1995 women clearly outnumbered men. Access to psychiatric care, unemployment, alcohol dependence, and previous sickness absence are suggested as possible factors that might affect the rates of disability pension in different geographical settings.

Adolescent↗
PubMed2006

Effect of benefits counseling services on employment outcomes for people with psychiatric disabilities.

OBJECTIVE: This study examined the impact of specialized benefits counseling services on levels of competitive employment for people with psychiatric disabilities receiving Social Security Administration (SSA) disability benefits in Vermont. METHODS: Beneficiaries who had a psychiatric disability and who received specialized benefits counseling (N = 364) were compared with matched contemporaneous and historical control participants over four years, two years before and two years after the initiation of the intervention. Study participants were consumers of vocational rehabilitation services, and the outcome measure was quarterly earnings from state unemployment insurance program records. Benefits counseling included general education regarding SSA disability programs, the various work incentives available under those programs, and other federal and state public benefits; individualized research and counseling regarding enrollees' current benefits packages; assistance in managing benefits through the transition to employment; and provision of information to supporting professionals. RESULTS: Participants who received specialized benefits counseling achieved significantly greater improvements in earnings. The benefits counseling group increased its adjusted average earnings by 1,256 dollars per year in comparison with the two control groups. CONCLUSIONS: Specialized benefits counseling appears to be an important employment support for Social Security Administration disability beneficiaries who have psychiatric disabilities.

Adolescent↗
PubMed2002

Behavioral health and managed care contracting under SCHIP.

This Policy Brief examines behavioral health managed care contracting under separately administered State Children's Health Insurance Programs (SCHIP), i.e., programs that operate under the direct authority of Title XXI of the Social Security Act rather than as expansions of Medicaid. Most separate SCHIP programs buy managed care style health insurance for some or most of their enrolled children. Because Title XXI provides states with far greater administrative flexibility than Medicaid with respect to coverage and benefit design, provision of services, and administration of managed care arrangements,studying separate SCHIP managed care products sheds important light on how states might approach insurance and managed care design generally in the area of behavioral health were Medicaid modified through section 1115 demonstration or federal statutory authority to permit greater latitude. To conduct this analysis, two nationwide databases maintained by the George Washington University Center for Health Services Research and Policy (CHSRP) were used: a database consisting of all Medicaid MCO-style managed care contracts in use in Calendar Year 2000; and a nationwide database consisting of contracts used by separate SCHIP programs for the same calendar year. As of the point of collection in 2000 there were 33 such separate programs; according to CMS' latest website information, that total has now reached 35. Both sets of contracts were analyzed and separated into their components by lawyers experienced in managed care contract analysis and interpretation. The data were entered into working tables that organize the contents of the contracts into a series of searchable domains.

Child↗
PubMedDate not supplied

[Remarks on operative regulations relating to decision making about inability to work in pension cases].

In years 1996 and 1997 both the Pension Act and the Social Insurance Act were changed in Poland and as a consequence of this, all the regulations relating to decision making about the inability to work. Having suppressed the so-called disability groups, such terms as permanent or temporary inability to work were introduced. Medical boards deciding on disability were replaced by predicative physicians working for the Social Insurance Department. Recently a rise in number of cases relative to the verification of the decisions passed by the SID and sent by either employer or Social Insurance Departments of district courts to the Department of Forensic Medicine Silesian Academy in Katowice has been observed. The authors have tried to analyse the cause of a rise in the number of appeals to a decision of the SID submitted by the insured.

Disability Evaluation↗
PubMed2005

Medicolegal decision making in noise-induced hearing loss-related tinnitus.

In some patients with occupational noise-induced hearing loss, a significant aspect of the handicap concerns the concomitant tinnitus; thus, this disorder must be considered in evaluating a disability percentage in the insurance context. The main difficulty comes from the lack of objective measures for tinnitus. To reach a maximum of medicolegal objectivity, a system was developed within the Belgian Institute of Occupational Disorders (Brussels) in the form of a four-level decision structure, after exhaustive but noninvasive assessment of patients. An aggregate of multiple-choice responses (affirmative, neutral, negative) to elementary questions leads to a decision of the next level, which in turn determines--together with the other decisions at the same level--the conclusion at a still higher level. A positive outcome on all four level-3 questions is required for recognition of noise-induced hearing loss-related tinnitus as an occupational disorder and for financial compensation (final decision, level 4). We assessed 10 exemplary files on which this system was applied by four experts rating independently. A variant of Cohen's Kappa for multiple raters demonstrated high interrater consistency at the first level. In all cases, the decisions at levels 3 and 4 were identical. In this way, the final medicolegal decision relies on standardized criteria and becomes perfectly transparent.

Decision Making↗
PubMed2005

Medicare coverage and reimbursement of outpatient prescription drugs in the US: history, recent changes and outlook for the future.

US Medicare provides health insurance to 41.5 million disabled and elderly Americans. Outpatient coverage, including a limited pharmacy benefit, is provided by Medicare Part B. Even with very restrictive criteria, Part B incurs 8.5 billion US dollars annually for outpatient prescription medications. Prior to passage of the Medicare Prescription Drug and Improvement Modernization Act (MMA) 2003, the Part B pharmacy benefit was criticised for its limited coverage criteria and flawed reimbursement practices. Despite the changes made under the MMA, these two issues continue to be concerns for the Medicare Part B outpatient prescription drug programme because (a) the criteria for selection of drugs for coverage do not necessarily reflect valuable advances in medicine, and the extent to which the new private-sector style 2006 Medicare Part D drug benefit will correct this is unknown; and (b) although pre-MMA average wholesale price-based reimbursement practices were clearly flawed, MMA changes such as use of the average sales price and providing increased reimbursement to physicians for drug administration may or may not be successful, and could lead to new problems. The extent to which the MMA and its associated Part D drug benefit address concerns and advance towards better, more cost-effective healthcare is reviewed and recommendations made.

Ambulatory Care↗
PubMed1982

Why veterans choose Veterans Administration hospitalization: A multivariate model.

Data from a national survey of veterans are analyzed to determine how age, income, health insurance and service-connected disability influence the veteran's choice of Veterans Administration (VA) hospitalization. Log-linear analysis is used to provide a model that expresses in numerically quantifiable terms (odds and odds ratios) the effects of these factors on the choice of VA hospitalization. Moreover, the multivariate nature of the analysis provides the opportunity for assessing the magnitude of these effect simultaneously in the presence of all other effects. The final model shows that age and health insurance act independently of each other and of all other factors. The effect of income is modified by service-connected disability status and vice versa; this interaction of two factors is probably due to VA hospital care eligibility criteria. Overall, the single most important factor affecting a veteran's choice of hospitalization is health insurance; veterans without health insurance have nearly five times greater odds of going to VA hospitals than do those with health insurance-regardless of age, income or service-connected disability status.

Age Factors↗