RESUMO
Underreporting of occupational diseases (OD) is a social and economic problem, because it has negative consequences for both the welfare of the affected workers and its impact on budgetary planning for the management of health services. We evaluated the healthcare costs of a sample of 13 cases of OD treated at a public hospital in Barcelona between 2014 and 2021, and officially accepted by the National Institute of Social Security (INSS). The total cost of care was 474,859, with an average cost of 36,528 per patient. By diagnostic group, the highest costs were associated with cancer cases, accounting for 79% of the total (375,068). The findings of this study reflect the economic impact of health care provided by a public hospital to patients with an OD recognized by the INSS.
La infranotificación de enfermedades profesionales (EEPP) es un problema social y económico, pues repercute en el bienestar del trabajador afectado, y en las estimaciones presupuestarias que se planifican anualmente para la gestión de los servicios sanitarios. Los costes asistenciales fueron evaluados en una muestra de 13 casos de EEPP con resolución positiva por el Instituto Nacional de la Seguridad Social atendidos en el Parc de Salut Mar (Barcelona) entre 2014 y 2021. El coste de la asistencia generada del total de casos fue de 474.859 , con un coste medio de 36.528 por paciente. Por grupo diagnóstico, el coste más alto lo originaron los casos de cánceres que supusieron el 79% del gasto total (375.068 ). Los hallazgos del estudio reflejan el impacto económico que supone la asistencia sanitaria prestada por un hospital público a pacientes con una EEPP reconocida en el INSS.
Assuntos
Doenças Profissionais , Previdência Social , Humanos , Custos de Cuidados de SaúdeRESUMO
We present a simple and practical tool that allows the usual distribution of the duration of non-occupational sick leave to be determined by medical diagnosis. A total of 2,646,352 episodes of medically certified sick leave, registered by the Catalan Institute of Medical Evaluations for the period 2006-2008, were followed to closure and were entered into a spreadsheet. Given its asymmetric distribution, the median duration of sick leave was 9 days. Musculoskeletal disorders were the most frequent diagnostic group (22.5%), while neoplasms had the longest median duration (56 days). The most common specific diagnoses were diarrhea-gastroenteritis (8.2%; median: 3 days) and acute rhinopharyngitis (5.2%; median: 4 days). The distribution of the duration of sick leave in a population varies by diagnosis and is asymmetric, with most episodes being much shorter than the mean duration. This finding is important for better clinical and administrative management of sick leave episodes.
Assuntos
Licença Médica/estatística & dados numéricos , Diagnóstico , Humanos , Espanha , Fatores de TempoRESUMO
The aim of this paper is to reflect, under the precautionary principle, on the relationship between scientific causation and legal liability in connection with a lawsuit regarding compensation for lack of occupational safety and hygiene controls following the death of a worker with mesothelioma that had been previously accepted as an occupational disease. The worker had spent 28 years as a shipyard welder, with a diagnosis of occupationally-related mesothelioma in 2007, and who died in 2009. After reviewing the advances in a) scientific knowledge on the health effects of asbestos exposure, which were consolidated between 1955 and 1976, and b) the development of a regulatory framework for the protection of workers in Spain that began generically in 1940 and became more specific in 1982, we conclude that our case probably would have benefited from application of the precautionary principle, which is now widely accepted.
El objetivo es reflexionar, bajo el principio de precaución, sobre la relación entre causalidad científica y responsabilidad legal, a propósito de una demanda en materia de recargo de prestación por falta de medidas de seguridad e higiene tras la muerte de un trabajador por mesotelioma, reconocida previamente como enfermedad profesional. Se trata de un trabajador que tras 28 años como soldador en unos astilleros, se le reconoció en 2007 un mesotelioma como enfermedad profesional, falleciendo en 2009. Después de valorar que a) el conocimiento científico de la relación de la exposición a amianto y el mesotelioma se consolida entre 1955 y 1976, y b) que la normativa legal para la protección de los trabajadores en España se inicia en 1940 con carácter genérico y en 1982 de manera específica, concluimos que nuestro caso posiblemente se hubiera beneficiado si el principio de precaución, que ahora está ampliamente aceptado, se hubiera aplicado.