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At least 19 recordsLinked to original sources
PubMed2005

Interdisciplinary collaboration between primary care, social insurance and social services in the rehabilitation of people with musculoskeletal disorder: effects on self-rated health and physical performance.

Previous research shows there can be good results from co-financing between welfare sectors on the perceived quality of interprofessional collaboration. However, little is known about the impact on patient outcome of such schemes. This study aimed to assess whether co-financed teams with personnel from primary care, social insurance and social services have any effect on patients' health status. A comparative study of patients attending health care centres with and without a co-financed collaboration model was carried out. Although research has shown positive results from co-financed collaboration on staff and organization, we could not find that this new interdisciplinary team structure gave a better patient health outcome than conventional care.

Adolescent↗
PubMed2003

Co-financing as a means to improve collaboration between primary health care, social insurance and social service in Sweden. A qualitative study of collaboration experiences among rehabilitation partners.

Collaboration between services has often been suggested as a means to increase effectiveness and reduce costs especially in the care and rehabilitation of long-term illness. In Sweden, a special legislation named SOCSAM was introduced in 1994, enabling financial collaboration between governmental and municipal authorities. In this paper we report on a qualitative study on collaboration around patients with musculoskeletal diseases. The aim of the study was to assess differences in goal formulation, collaboration and communication between staff in intervention health centres that have implemented co-financing projects and health centres working under conventional conditions. Focus group interviews were performed with staff at intervention and control health care centres. We found that the interdisciplinary collaboration had improved in the intervention health care centres compared to the controls. Our findings suggest that co-financing can enhance development of better forms of interdisciplinary and interorganisational collaboration through legitimising formulation of common long-term goals, while emphasising mutual benefits.

Cooperative Behavior↗
PubMed2000

Germany's long-term-care insurance: putting a social insurance model into practice.

A growing population of elderly has intensified the demand for long-term care (LTC) services. In response to the mounting need, Germany put into effect a LTC Insurance Act in 1995 that introduced mandatory public or private LTC insurance for the entire population of 82 million. The program was based on the organizational principles that define the German social insurance system. Those individuals in the public system and their employers each pay contributions equal to 0.85 percent of each employee's gross wages or salary. Ten percent of the population with the highest incomes have chosen the option of purchasing private long term care insurance. Provisions were made for uniform eligibility criteria, benefits based on level of care needs, cost containment, and quality assurance. Over the first four years of its operation, the system has proved financially sound and has expanded access to organized LTC services. The German system thus may serve as an example for other countries that are planning to initiate social LTC insurance systems in other nations.

Aged↗
PubMed1998

Social insurance cost of standard discectomy and percutaneous nucleotomy. A retrospective study of 87 social insurance claim files of male blue collar workers.

A retrospective review of social insurance claim files of male blue collar workers was conducted to compare the social insurance costs of percutaneous lumbar nucleotomy with standard lumbar discectomy ; 29 percutaneous nucleotomy procedures were matched with 58 standard discectomies all carried out between January 1992 and December 1994. It was concluded that a standard discectomy procedure results in significantly higher costs during hospitalisation with respect to surgery, anaesthesia and hospital stay. A percutaneous nucleotomy leads to a significantly higher outpatient expenditure especially in radiology and medical devices. The relative proportion of outpatient practitioner's visits and hospital stay costs was significantly higher for the standard discectomy whereas medical devices had a relatively higher share in outpatient expenditure for the percutaneous nucleotomy. In this population of 87 compensation claimants, the average social insurance costs did not significantly differ between the percutaneous nucleotomy and the standard discectomy.

Absenteeism↗
PubMed1986

Social insurance and the delivery of social services in France.

An outline of the organization of the French social insurance and the social service delivery system is given. It is shown that the social insurance system, more so than in most other welfare states, strongly reflects various class and occupational interests. Therefore, it is also more prone to conflict along class lines, while other countries' social insurance systems tend to blurr class conflict. In addition, problems due to demographic shifts and economic changes are discussed and the populations affected, particularly the aged, identified. Some of the government's strategies to ameliorate the financial problems of the social insurance system are mentioned. The social service delivery system is found to suffer from bureaucratization and inefficiency. In order to correct this and to improve the quality of services, France has begun to decentralize the social service delivery system. There is little evidence, though, that decentralization, as presently practiced, is able to significantly improve the appropriateness of social services and increase the efficiency with which they are delivered. On the contrary, the political forces opposed to an elaborate welfare state tend to be strengthened. No doubt, the aged would also be affected by such political changes.

France↗
PubMed1992

Financing universal health insurance: taxes, premiums, and the lessons of social insurance.

In a society with strong antitax sentiment and large government deficits, the enactment of universal health insurance is blocked by an impasse over financing. The two chief mechanisms for funding universal health insurance are taxes and insurance premiums. Taxes and premiums are not distinct entities; rather, a spectrum of financing methods exists with varying tax-like and premium-like features. Premium-like financing tends to be voluntary and earmarked for health care, with coverage contingent upon making payments and payments going to private insurance firms. Tax-like financing, in contrast, tends to be mandatory and not earmarked for health care, with coverage not dependent upon making payments and payments going to governments. Over the past century, most industrialized nations have developed highly popular social insurance programs to cover periods of retirement, disability, unemployment, and payment for medical care. Social insurance constitutes a blend of tax-like and premium-like features, offering lessons that might assist in breaking the current impasse over universal health insurance financing.

Fees and Charges↗
PubMed2004

How can a work rehabilitation process be improved?--a qualitative study from the perspective of social insurance officers.

PURPOSE: The aim of this study is to describe social insurance officers' experiences of a work rehabilitation process at a rehabilitation centre in the northern parts of Sweden. In Sweden the social insurance company has a key role to coordinate all efforts concerning work rehabilitation planning between all rehabilitation actors. METHOD: Ten social insurance officers at the social insurance company in a city in northern Sweden were interviewed using a narrative approach about their experiences of work rehabilitation processes in general. The interviews were analysed by qualitative content analysis with a focus on their experiences of goals, content and results of a work rehabilitation process. RESULTS: The social insurance officers' experiences of how a work rehabilitation process could be improved were described in six categories; (1) Early identification of problems, needs and interventions (2) clear goal formulations, (3) a focus on psychosocial factors (4) a greater variety of possible interventions, (5) activating employers to a higher extent in work rehabilitation and (6) a closer cooperation and information exchange with other rehabilitation actors. CONCLUSIONS: It is possible to improve a work rehabilitation process by focusing on early identification of problems, needs and interventions, with a variety of interventions to choose between and with clear goal formulations and recognizing psychosocial factors in the process. To activate employers to a higher extent in work rehabilitation and to make the information exchange between rehabilitation actors more frequent may also improve work rehabilitation processes.

Adult↗
PubMed1988

[Occupational accidents in the light of the records of the Institute of Social Insurance].

The records of the Social Insurance Institute Department in Poznań have been used as the study material. The area of the study covered the whole province of Poznań. The study included only people employed in the State-controlled economy. Applied in the study have been certificate records of the Social Insurance Institution related to individuals applying for financial benefits and entitled to them as victims of accidents at work (health damage, disability) in 1985. The records of 3119 workers (2380 men and 739 women) were analysed. Accidents at work were found to be 2.8 times more frequent among workmen, as compared to people carrying on other than physical work. The accident rate was higher among men than among women; the difference was more distinctive in physical workers (2.7:1) than in those performing other types of work (1.3:1). 37.5% of all accidents affected the workers who had been accident victims before. A clear weekly rhythm of accidents was observed: most of them happened on Wednesday. 11 o'clock was noted as the most fatal time. Most frequent accidents were: all kinds of falls (28.8%), hand injuries (34.5%), occurring mostly during transportation or when operating a machine. In the majority of cases the accidents resulted in slight health damages; in 23.0% of victims no essential health damages were found, they were the so-called zero damages. Finger injuries occur most frequently in physical workers, whereas injuries of ankle-joints, feet and head--in those performing other types of work.

Accidents, Occupational↗
PubMed2002

Redistributive effects of the Swedish social insurance system.

BACKGROUND: Four principles are used to distribute payments via the Swedish social-insurance system in cases of temporary or permanent illness and death. This paper studies the redistributive effects on income of these four principles. METHODS: The analysis is based on aggregate social-insurance data from the 25 municipalities that comprise Stockholm County in Sweden. For nine different types of social-insurance payments based on the four principles, the degree of income redistribution is measured according to concentration indexes and differences between Gini coefficients with social-insurance payments excluded and included. RESULTS: The concentration indexes for payments from the nine social-insurance schemes in total is -0.0469. The Gini coefficient falls from 0.0437 excluding insurance payments (i.e. for income only from gainful work, IGW) to 0.0379 when including insurance payments with income from gainful work (IGW + TP). That is, the Gini coefficient is 15% lower when insurance payments are included. Decomposition by payment shows that the largest redistribution effect on income inequality is made by disability pension. CONCLUSION: Municipalities with low average income are favoured by the Swedish social-insurance system. Payment principles can be ranked according to their redistributive capacity: mix of compensating-lost-income and flat-rate, compensating-lost-income, means-testing, flat-rate, and need-based respectively. The nine social-insurance schemes contribute very differently to income redistribution. Disability pension and sickness allowance contribute most to income redistribution and reducing income inequality.

Cost of Illness↗
PubMed2003

Clients' perceptions of contact with professionals within healthcare and social insurance offices.

AIMS: An increasing number of people interact with professionals within healthcare and social insurance offices during periods of sick leave due to musculoskeletal disorders. Knowledge of clients' perceptions of such contact is scarce. This study analysed clients' perceptions of their contact with professionals within healthcare and social insurance offices. METHODS: A cohort study was conducted in the municipality of Linköping, Sweden. Participants were all citizens who in 1985 were aged 25-34 years and had at least one new sick-leave spell due to back, neck, or shoulder diagnoses exceeding 28 days (n = 213). In 1996, 11 years after inclusion, a questionnaire about perception of contact with professionals, self-perceived health, and mental health was administered. Register data on sickness absence and disability pension from 1985-96 were also obtained. RESULTS: Factor analysis indicated the existence of three dimensions of contact with professionals: supportive treatment, distant treatment, and empowering treatment. Women perceived their contact with both social insurance officers and healthcare professionals as more supportive than did the men. Respondents with disability pensions perceived their contact with social insurance officers as more supportive and empowering than persons without disability pensions. Respondents with mental health problems perceived their contact with both types of professionals as more distant. Respondents with neck/shoulder diagnoses perceived their contact with healthcare professionals as more empowering than respondents with low back diagnoses. CONCLUSION: There was a relationship between clients' perceptions of contact with professionals and the sex, disability pension, diagnosis, and mental health of clients.

Adult↗