Reimbursement for injury-induced medical expenses in Chinese social medical insurance schemes: A systematic analysis of legislative documents.

Social medical insurance schemes are crucial for realizing universal health coverage and health equity. The aim of this study was to investigate whether and how reimbursement for injury-induced medical expenses is addressed in Chinese legislative documents relevant to social medical insurance. We retrieved legislative documents from the China National Knowledge Infrastructure and the Lawyee databases. Four types of social medical insurance schemes were included: urban employee basic medical insurance, urban resident basic medical insurance, new rural cooperative medical system, and urban and rural resident medical insurance. Text analyses were conducted on all identified legislative documents. As a result, one national law and 1,037 local legislative documents were identified. 1,012 of the 1,038 documents provided for reimbursement. Of the 1,012 documents, 828 (82%) provided reimbursement only for injuries without a legally responsible person/party or not caused by self-harm, alcohol use, drug use, or other law violations, and 162 (16%) did not include any details concerning implementation. Furthermore, 760 (92%) of the 828 did not provide an exception clause applying to injuries when a responsible person/party could not be contacted or for situations when the injured person cannot obtain reimbursement from the responsible person/party. Thus, most Chinese legislative documents related to social medical insurance do not provide reimbursement for medical expenses from injuries having a legally responsible person/party or those caused by illegal behaviors. We argue that all injury-induced medical expenses should be covered by legislative documents related to social medical insurance in China, no matter what the cause of the injury. Further research is needed to explore the acceptability and feasibility of such policy changes.

[Social security and labor absenteeism in a regional health service]. / Efecto de la seguridad social en la duración del ausentismo laboral en el Servicio de Salud de Ñuble: un análisis de supervivencia.

BACKGROUND: Absenteism can generate important economic costs. AIM: To analyze the determinants of the time off work for sick leaves granted to workers of a regional health service. MATERIAL AND METHODS: Information about 2033 individuals, working at a health service, that were granted at least one sick leave during 2012, was analyzed. Personal identification was censored. Special emphasis was given to the type of health insurance system of the workers (public or private). RESULTS: Workers ascribed to the Chilean public health insurance system (FONASA) had 11 days more off work than their counterparts ascribed to private health insurance systems. A higher amount of time off work was observed among older subjects and women. CONCLUSIONS: Age, gender and the type of health insurance system influence the number of day off work due to sick leaves.

Efecto de la seguridad social en la duración del ausentismo laboral en el Servicio de Salud de Ñuble: un análisis de supervivencia / Social security and labor absenteeism in a regional health service

Background: Absenteism can generate important economic costs. Aim: To analyze the determinants of the time off work for sick leaves granted to workers of a regional health service. Material and Methods: Information about 2033 individuals, working at a health service, that were granted at least one sick leave during 2012, was analyzed. Personal identification was censored. Special emphasis was given to the type of health insurance system of the workers (public or private). Results: Workers ascribed to the Chilean public health insurance system (FONASA) had 11 days more off work than their counterparts ascribed to private health insurance systems. A higher amount of time off work was observed among older subjects and women. Conclusions: Age, gender and the type of health insurance system influence the number of day off work due to sick leaves.

Social Security income measurement in two surveys.

As a major source of income for retired persons in the United States, Social Security benefits directly influence economic well-being. That fact underscores the importance of measuring Social Security income accurately in household surveys. Using Social Security Administration (SSA) records, we examine Social Security income as reported in two Census Bureau surveys, the Survey of Income and Program Participation (SIPP) and the Current Population Survey (CPS). Although SSA usually deducts Medicare premiums from benefit payments, both the CPS and the SIPP aim to collect and record gross Social Security benefit amounts (before Medicare premium deductions). We find that the Social Security benefit recorded in the CPS closely approximates the gross benefit recorded for CPS respondents in SSA's records, but the Social Security benefit recorded in the SIPP more closely approximates SSA's record of net benefit payments (after deducting Medicare premiums).

Principles of social security and health insurance for farmers in Poland and Germany--a comparative assessment.

INTRODUCTION AND OBJECTIVE: As landowners occupied with agricultural production comprise a sizeable part of the populations in mid- and western European countries, it seemed reasonable to assess the organization of health care systems concerning farmers and their families in Poland and Germany. Both countries have similar geographical conditions and rural environments. It so happens that in Poland the principles of the system of agricultural insurance (KRUS) is based on the experiences of Germany and France. STATE OF KNOWLEDGE: Basically, both in Poland and Germany, the agricultural health insurance companies provide the same insurance cover as other health insurance companies. In both countries, under certain conditions, in the case of illness, the insured farmers receive instead of sickness benefit operational assistance and home help. In spite of the similarities that characterize both administrations, many particular differences are to be noted, e.g. the farmers' social insurance in Poland is subject to only one ministry, in contrast to Germany where two ministries are responsible for farmers' social insurance. In Poland, KRUS is a monopolistic organization, whereas in Germany, nine similar independent structures fulfil the task of a health insurance company. Needless to say, many more funds are available for prevention, treatment and rehabilitation in Germany than in Poland, due to obvious differences in the overall national income.

Comparing epidemiologically estimated treatment need with treatment provided in two dental schemes in Ireland.

BACKGROUND: Valid estimation of dental treatment needed at population level is important for service planning. In many instances, planning is informed by survey data, which provide epidemiologically estimated need from the dental fieldworkers' perspective. The aim of this paper is to determine the validity of this type of information for planning. A comparison of normative (epidemiologically estimated) need for selected treatments, as measured on a randomly-selected representative sample, is compared with treatment actually provided in the population from which the sample was drawn. METHODS: This paper compares dental treatment need-estimates, from a national survey, with treatment provided within two choice-of-dentist schemes: Scheme 1, a co-payment scheme for employed adults, and Scheme 2, a 'free' service for less-well-off adults. Epidemiologically estimated need for extractions, restorations, advanced restorations and denture treatments was recorded for a nationally representative sample in 2000/02. Treatments provided to employed and less-well-off adults were retrieved from the claims databases for both schemes. We used the chi-square test to compare proportions, and the student's t-test to compare means between the survey and claims databases. RESULTS: Among employed adults, the proportion of 35-44-year-olds whose teeth had restorations was greater than estimated as needed in the survey (55.7% vs. 36.7%;p <0.0001). Mean number of teeth extracted was less than estimated as needed among 35-44 and 65+ year-olds. Among less-well-off adults, the proportion of 16-24-year-olds who had teeth extracted was greater than estimated as needed in the survey (27.4% vs. 7.9%;p <0.0001). Mean number of restorations provided was greater than estimated as needed in the survey for 16-24-year-olds (3.0 vs. 0.9; p <0.0001) and 35-44-year-olds (2.7 vs. 1.4;p <0.01). CONCLUSIONS: Significant differences were found between epidemiologically estimated need and treatment provided for selected treatments, which may be accounted for by measurement differences. The gap between epidemiologically estimated need and treatment provided seems to be greatest for less-well-off adults.

Social security in Africa: a brief review.

Africa is the poorest region of the world and has the youngest and least developed social security programs. Most Africans are not covered by social security programs. The high prevalence of HIV/AIDS in some sub-Saharan countries and internal armed conflicts in others have created difficult problems in some countries for social security programs. As a result, some countries do not have functioning social security programs. The social security programs that do exist in Africa are influenced by their colonial heritage, with the programs in English-speaking Africa differing from those in French-speaking Africa. Six different patterns of social security provision can be identified.

EUM: antihipertensivos en la Seguridad Social y análisis comparativo entre Centros de Atención Médica Ambulatoria / EUM: antihipertensives in the Social Security and comparative analys between Ambulatory Medical Attention

Justification: Systemic hypertension is a chronic and asymptomatic disease. It is the first cause of ambulatory medical visits. It contributes directly to the first cause of mortality in the country, and it is almost always treatable with an integral intervention which includes pharmacological ...

A global perspective on statutory Social Security programs for the sick.

Statutory sickness benefit programs have been adopted in 129 countries. Most have an employment-based strategy, social insurance, that restricts coverage to those in paid formal employment. The cash entitlements provided are predominantly earnings-related. Funding comes overwhelmingly from employer and employee contributions, with only a minority of countries providing government subsidies. A comparative-evaluative assessment methodology is used to assess national statutory intentions with respect to statutory social security provision for the sick. The best-designed statutory program is found in Sweden followed closely by France and then Australia, Austria and Germany. Algeria clearly leads the African rankings, as does Peru in Latin America, Iraq in the Middle East, and Nauru in the Pacific Islands. Turkmenistan has the best-designed statutory program in Asia, by a very small margin. In North America, Canada is well ahead of the United States.

Reforma previdenciária: vetores do debate contemporâneo / Social security reform: vectors of contemporary debate

Apresenta trabalhos sobre o futuro da seguridade social, o debate internacional das reformas previdenciarias na America Latina, o financiamento do desenvolvimento no Brasil de entidades de previdência privada e a questäo contribuitiva e os institutos e fundos de pensäo na previdência dos servidores públicos (CAC)

La ley 100: indicación, dosis y toxicidad

La Ley 100 de 1993 marcará un cambio trascendental en la salud en Colombia. Y es la traducción de la preocupación gubernamental por la baja cobertura en salud, por la ineficiencia y por la desarticulación de las instituciones, lo que ha hecho que la ley sea en principio universal, solidaria, eficiente, equitativa, obligatoria y de libre escogencia