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At least 1,531 records · Page 85Linked to original sources
PubMed2005

Increase of mild disability in Japanese elders: a seven year follow-up cohort study.

BACKGROUND: Japan has the highest life expectancy in the world. In a 2002 census government report, 18.5% of Japanese were 65 years old and over and 7.9% were over 75 years old. In this ageing population, the increase in the number of dependent older persons, especially those with mild levels of disability, has had a significant impact on the insurance budget. This study examines the increase of mild disability and its related factors. METHODS: All community-dwelling residents aged 65 and over and without functional decline (n = 1560), of Omishima town, Japan, were assessed in 1996 using a simple illustrative measure, "the Typology of the Aged with Illustrations" to establish a baseline level of function and were followed annually until 2002. The prevalence and incidence of low to severe disability, and their association with chronic conditions present at the commencement of the study, was analyzed. A polychotomous logistic regression model was constructed to estimate the association of each chronic condition with two levels of disability. RESULTS: An increase in mild functional decline was more prevalent than severe functional decline. The accumulation of mild disability was more prominent in women. The major chronic conditions associated with mild disability were chronic arthritis and diabetes in women, and cerebrovascular accident and malignancy in men. CONCLUSION: This study showed a tendency for mild disability prevalence to increase in Japanese elders, and some risk factors were identified. As mild disability increasingly prevalent, these findings will help determine priorities for its prevention in Japanese elders.

Activities of Daily Living↗
PubMed2000

Does personality or psychopathology predict disability in chronic pain patients?

PURPOSE: The purpose of this study was to evaluate the usefulness of personality characteristics, depression and personality disorders in predicting disability status in pain patients one year later. METHOD: Subjects were 250 volunteer chronic pain patients. The baseline evaluation consisted of the Karolinska Scales of Personality and psychiatric evaluation of depression and personality disorders using standardized diagnostic instruments. Disability status was assessed by insurance record review one year after the evaluation. RESULTS: The results suggest that baseline personality traits and psychopathology (i.e. depression or personality disorders) were not useful predictors of disability status in pain patients with one-year follow-up. CONCLUSIONS: These data suggest that personality characteristics and psychopathology are probably not important disability predictors in chronic pain patients.

Adult↗
PubMed2005

How do persons with intellectual disability manage in the open labour markets? A follow-up of the Northern Finland 1966 Birth Cohort.

BACKGROUND: The aim was to study how many of the individuals with intellectual disability (ID; IQ < or = 70) in an age cohort were not receiving a disability pension by the age of 34 years and what their life situation was like in terms of employment, education and morbidity. In 2000, the Northern Finland 1966 Birth Cohort (n=12,058 live-born) included 129 individuals with ID. METHOD: The outcome data on employment, education, pensions and morbidity were obtained from national registers. RESULTS: A total of 85.3% (n=110) of all the individuals with ID were on pension, and 66 of them had severe ID (IQ <50) and 44 had mild ID (IQ 50-70). Altogether 99 were drawing a pension because of ID, and 11 had a main diagnosis other than ID in the register of Social Insurance Institution. Nineteen individuals with mild ID were not on disability pension. The educational level of those without pension was low, and all whose occupation was known worked in low-level manual trades in the open labour market. During the past 8 years (1993-2000), their employment rate had been lower and unemployment rate correspondingly higher and unemployment periods longer than those of the reference group (IQ >85 or not measured). As to the morbidity, they had been hospitalized twice more often than those in the reference group and the mean of their hospitalization days was over fourfold. CONCLUSION: More attention should be paid to the vocational education and supported employment services of individuals with ID to help them to manage as independently as possible.

Adult↗
PubMed2003

[Veterinarian: a healthy profession?].

Data of the insurance company Movir reveals that veterinarians are more often occupationally disabled compared to other occupations. The causes for this disability are: problems with the locomotion apparatus, accidents and psychological problems. Regarding the complaints of the locomotion apparatus is found that proportionally between 51 and 65 years there are more vets disabled. In absolute numbers the majority of the problems at Movir involves the farm animal vet. About the relative importance or indemnities of other insurance companies no statements can be made. The localisation of the affections are: lower back, knees, shoulders, neck and wrist/hand. Regarding the accidents is found that a lot of problems happen in the private situation, but that the high percentage of disability caused by accidents compared with other professions is probably caused by the profession related accidents. From the numbers of Movir comes forth that especially working with horses is dangerous, but there is no specific veterinarian skill very risky. Regarding the psychological problems comes forth that there are no differences between men and women. Proportionally from 46 years until 65 years there is a higher incidence of burnout then at younger ages. In absolute numbers more companion animal vets are burnout, but no statements can be made about the relative importance. There is no difference at Movir between the solopractice and the partnership regarding burnout. The professional circumstances playing a role in developing burnout are: a too high workload, problems with colleagues within the partnership, irregular shifts, organisation and management and financial management. The personal aspects of these veterinarians that play a role in burnout are: high expectations and demands, perfectionism and insecurity about the own abilities. In many of the files there were also problems within the private situation.

Accidents↗
PubMed1993

[Comments on simulation and experts. A contribution from forensic practice].

The report deals with an insurant (private accident and health insurance), who succeeded in deceiving the university hospital of his mothertown for a long time and in a cost intensive way after he had an alleged concussion followed by an extreme, consecutive decline of his ability to see. The malingerer finally processed some documents, which forced the person inchange in case of a high percentage of disability to pay a sum insured of about one million DM or more. In the practice of an expert it was possible to find him guilty in a simple and cheap way.

Accidents, Occupational↗
PubMedDate not supplied

Predisposing factors for self-inflicted burns.

Self-inflicted burn injuries, although uncommon, are a significant source of morbidity and mortality. The purpose of this study was to delineate the characteristics of these burns and to examine their impact on society. Records of 32 adult patients admitted for self-inflicted burns at our regional burn center between January 1996 and August 2001 were retrospectively reviewed. The mean burn size was 34 +/- 29% TBSA, with the majority of burns being the result of self-immolation using a flammable liquid. There was a slight male predominance (59%) and a significant mortality rate (25%). Ninety-one percent of patients had an active psychiatric diagnosis, with 47% having had a previous suicide attempt. Two thirds had a chronic stressor, such as a chronic medical illness and/or long-term disability. Only four patients had private insurance, whereas the remainder relied on underfunded state- and county-sponsored programs or were uninsured. In addition to well-described psychiatric factors, common characteristics predisposing to self-inflicted burns include chronic medical illnesses, long-term disability, and a lack of access to adequate mental health care. Better treatment of mental illness in the underfunded population might ultimately save the high costs of these burn injuries.

Adolescent↗
PubMed1981

[Sociomedical aspects of cancer of the uterine cervix (author's transl)].

Statistics on long-term results in the treatment of cancer of the cervix are usually based on clinical data, so that they are not sufficiently randomized. The author attempted to follow up the subsequent fate of patients with cancer of the cervix who had been granted a disability pension from the sickness insurance fund of the workers' compensation board in North-Rhine Westphalia effective 1969/1970. In view of the fact that after a lapse of 8 to 9 years it is no longer possible to obtain medical data as completely as would be desirable, the inquiry was limited to finding out the amount paid out every month, the old-age pension, and the year of death. 30.5% of the 583 pensioners had died, whereas 30.5% were still recipients of disability pension because of this disease, and 17.0% had in the meantime become old-age pensioners (2.6% cancellations of pension payments and 19.4% pensions for a limited period). Of the 178 deceased, 76.5% died already within the first 3 years after having been granted the pension; thereafter, the annual death rates decreased continually by 6.5% to 2.8%. Attention is drawn to the advantages offered by a pension for a limited time with the possibility of getting it extended. The results of this study are supplemented by statistics on mortality, ability to work and amount of pension granted, as well as references from literature on the incidence and long-term results in carcinoma of the cervix.

Adult↗
PubMed1999

Clinical practices in the management of new-onset, uncomplicated, low back workers' compensation disability claims.

Recent consensus guidelines delineate what appears to be the most successful and cost-effective management of low back pain (LBP), and some recent studies have suggested that better outcomes occur with the least aggressive forms of medical intervention. The purpose of this study was to describe how practitioners manage new-onset, uncomplicated low back workers' compensation (WC) disability cases. A sample of cases was randomly selected from a large insurance carrier's national data source. An effort was made to select only uncomplicated cases, which would be expected to have relatively minimal need for medical intervention. There was an apparent overuse of diagnostic and treatment modalities. Diagnostic imaging was overutilized, not only in terms of the number of studies done (65% had plain films, 22% had magnetic resonance imaging scans) but also in the time frame in which they were performed (38% had plain films on the first clinic visit). Ninety percent received at least one medication, and 38% received more than one prescription for opioid analgesics. Expensive non-steroidal anti-inflammatory drugs were prescribed more often than acetaminophen (61% versus 6%, respectively). Sixty-two percent received physical therapy that often included modalities with as yet unproven efficacy. Overutilization of either diagnostic or treatment procedures increases the likelihood of iatrogenic complications, is not cost-effective, and may adversely impact clinical and occupational outcomes.

Adolescent↗
PubMedDate not supplied

[Injury versus illness of the knee--an important problem in rating permanent impairment].

Consequences of knees injuries constitute a substantial number of personal claims within the PZU Group. In 2004 physicians cooperating with PZU gave about 53 thousand opinions, concerning injuries to the knee in adults and about 14 thousnd in children and adolescents. In accidental and TPL insurances physicians are obligated to treat separatly consequences of accidents due to impact from illness or earlier injuries. The lack of a good method of how to distinguish these often leads to the disaccords between the physician, client and insurance company. The aim of this research is to indicate and to define the medical problems during rating of permanent impairment, based on the analysis of hundreds of difficult claims. This may help to start a discussion on how to perform objective and repetitive method of rating permanent accidental impairment in the knee ailments. In our opinion, current rules of rating permanent impairment after injury in a damaged organ, do not guarantee a detailed assessment of accidental loss of knee function during medical examination.

Adolescent↗
PubMed2002

Readiness for return to work following injury or illness: conceptualizing the interpersonal impact of health care, workplace, and insurance factors.

Return to work after injury or illness is a behavior influenced by physical, psychological, and social factors. Disability research lacks a conceptual framework for combining these factors in the study of the return-to-work process. Two extant theoretical models within the social context are considered as they apply to the behavior of returning to work: 1) the Readiness for Change Model originating from the field of health promotion and addressing the issue of motivation for behavior change, and 2) the Phase Model of Disability developed for the epidemiological study of occupational disability addressing the developmental and temporal aspects of disability. A new Readiness for Return-to-Work Model is proposed focusing on the interpersonal context of the work-disabled employee. Employee interactions with the workplace, the health care, and insurance systems are considered as they impact the three defining dimensions of change--decisional balance, self-efficacy and change processes. The evidence for their impact on return-to-work is examined within the framework of the Phase Model of Disability, which puts forth the phase-specificity of symptoms, risks, and interventions for disability. The Readiness for Return-to-Work Model has the potential to account for individual variation in optimal stage-specific timing of interventions based on an individual's readiness for return-to-work. The model therefore complements the Phase Model of Disability by allowing for an individual-level staging of the disability and recovery process within the broader group-level-derived framework of occupational disability phases. This link between the two models needs to be empirically tested in future research.

Accidents, Occupational↗
PubMed1997

Managed disability--past, present and future.

This article discusses the overall development of managed disability. First, it explores historical factors that have influenced managed disability programs, followed by important considerations in current programs, and finally discusses future issues to contemplate for successful evolution to occur. The authors conclude by pointing out the opportunity for insurers to develop innovative and responsive products and the opportunity for employers to have a direct impact on reshaping disability benefit programs.

Absenteeism↗
PubMed1993

Health care reform and people with disabilities.

As a group, people with disabilities or chronic conditions experience higher-than-average health care costs and have difficulty gaining access to affordable private health insurance coverage. While the Americans with Disabilities Act will enhance access by prohibiting differential treatment without sound actuarial justification, it will not guarantee equal access for people in impairment groups with high utilization rates. Health care reform is needed to subsidize the coverage of such individuals. Such subsidization can be achieved under either a casualty insurance model, in which premiums based on expected costs are subsidized directly, or a social insurance model, in which low-cost enrollees cross-subsidize high-cost enrollees. Cost containment provisions that focus on the provider, such as global budgeting and managed competition, will adversely affect disabled people if providers do not have adequate incentives to meet these people's needs. Provisions focusing on the consumer, such as cost sharing, case management, and benefit reductions, will adversely affect disabled people if they unduly limit needed services or impose a disproportionate financial burden on disabled people.

Adolescent↗