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Disability documents of all diabetic persons (n = 1,707) granted a disability pension in Sweden during 1980 were studied. The following factors were analysed: age, sex, civil status, profession, unemployment, being a housewife, immigration status, form for disability pension application, duration of diabetes, type of treatment, presence of classical late complications and age at onset of diabetes, obesity and alcohol problems. Functional handicaps and symptoms related to a clinically advanced diabetes mellitus could be regarded as the basis for the decision to grant a disability pension to 20-25% of the pensioners. For the remaining 75-80% neither the diabetic state nor its late complications could be held responsible for reduced work capacity. Rather, symptoms like angina pectoris and rheumatic symptoms and many other factors such as obesity, alcohol problems, being an immigrant, or being unemployed influenced the decision to grant a disability pension.
One hundred and eighty-eight and 167 first applications for disability pensions in 1981 and 1985 respectively were examined. Social parameters, diagnoses and the occurrence of alcohol and drug abuse were studied. There was a decrease in the number of male applicants and a small increase of female applicants from 1981 til 1985. Unskilled workers were overrepresented. Most applicants had been working within the last two years before the pension was awarded, and generally they had had long job periods. In 1985, had only 27% of the applicants under 50 attempted rehabilitation, and 12% had received social security allowances. The new types of social pensions were mostly awareded to married women of more than 50 years of age. Pensioning caused by a combination of social and health circumstances was rare. Female applicants were generally awarded lower pensions than male applicants. More than half of the diagnoses included mental diseases, diseases of the musculo-skeletal system and disease of the circulation. In 1985, 15% of the applicants were abusers, mainly of alcohol. 50% of male applicants younger than 50 years of age were abusers. The abusers were very disabled.
The consumption of benzodiazepines and potent analgesics by old age pensioners and early retirees in Odense who had the right to receive medicine free-of-charge was accounted for where the month of March 1990 was concerned. Approximately 26% received financial support for benzodiazepines, 13% for analgesics while further 6% received support for both benzodiazepines and analgesics. The majority of the users were over 60 years and there twice as many women as men. No significant differences were observed in the sex and age distributions between the groups of pensioners who received benzodiazepines and/or analgesics and the group which received only other medicine. Both the direct and the indirect expenses are discussed. Furthermore, it is concluded that, in some of the pensioners, over-consumption is involved and that it is again necessary to emphasize the indications for prescription of these preparations.
The authors discuss recruitment to disability pension in groups of former pupils of different types of school in the school system in Bergen in the 1950s. The study is based on a cohort of 1,570 persons, all live births from 1940 of the mothers then residing in Bergen. This birth-cohort was followed up in the school system in Bergen at the age of 14 years and up to the end of 1992. Information on disability pensions was extracted from the files of the National Insurance Administration for the years 1967-92. The prevalence of disability pension of former pupils of different types of school reached a peak at the end of 1992, i.e. at the age of 52 years, as follows: Former pupils of the regular secondary schools, i.e. junior high school and continuation school, 6.8% and 12.7% respectively, former pupils of elementary school classes for slow learners 25.9%, of special schools for the educable mentally retarded 59.6% and for those receiving the services for the mentally retarded, 100%.
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.
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.
Against the background of the demographic development, the question is whether an old age income security system which is based on the pay-as-you-go principle is still in accordance with the principle of intergenerational solidarity. The article examines significant dimensions of a fair distribution of income between different generations and asks for the respective implications of the German pension reform 2001. The article finishes by concluding that even an old age income security system on a private basis which is based on the capital stock system cannot prevent future cohorts of younger generations from having a higher burden.
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