Exploring the relationship between age and tenure with length of disability.

BACKGROUND: The aging of the workforce, coupled with the changing nature of career tenure has raised questions about the impact of these trends on work disability. This study aimed to determine if age and tenure interact in relating to work disability duration. METHODS: Relationships were investigated using random effects models with 239,359 work disability claims occurring between 2008 and 2012. RESULTS: A 17-day difference in the predicted length of disability was observed from ages 25 to 65. Tenure moderated the relationship between age and length of disability. At younger ages, the length of disability decreased as tenure increased, but at older age, the length of disability increased as tenure increased. DISCUSSION: Results indicate that although there is a relationship between length of disability and tenure, age makes a greater unique contribution to explaining variance in length of disability. Future research is needed to better understand why specifically age shows a strong relationship with length of disability and why that relationship varies with age.

Sickness absence patterns and trends in the health care sector: 5-year monitoring of female municipal employees in the health and care sectors in Norway and Denmark.

BACKGROUND: Sickness absence is a growing public health problem in Norway and Denmark, with the highest absence rates being registered in Norway. We compared time trends in sickness absence patterns of municipal employees in the health and care sectors in Norway and Denmark. METHODS: Data from 2004 to 2008 were extracted from the personnel registers of the municipalities of Kristiansand, Norway, and Aarhus, Denmark, for 3,181 and 8,545 female employees, respectively. Age-specific comparative statistics on sickness absence rates (number of calendar days of sickness absence/possible working days) and number of sick leave episodes were calculated for each year of the study period. RESULTS: There was an overall increasing trend in sickness absence rates in Denmark (P = 0.002), where rates were highest in the 20-29- (P = 0.01) and 50-59-year-old age groups (P = 0.03). Sickness absence rates in Norway were stable, except for an increase in the 20-29-year-old age group (P = 0.004). In both Norway and Denmark, the mean number of sick leave episodes increased (P <0.0001 and P <0.0001, respectively) in all age groups except for the 30-39- and 60-67-year-old age groups. The proportion of employees without sickness absence was higher in Norway than in Denmark. Both short-term and long-term absence increased in Denmark (P = 0.003 and P <0.0001, respectively), while in Norway, only short-term absence increased (P = 0.09). CONCLUSIONS: We found an overall increase in sickness absence rates in Denmark, while the largest overall increase in sick leave episodes was found in Norway. In both countries, the largest increases were observed among young employees. The results indicate that the two countries are converging in regard to sickness absence measured as rates and episodes.

Absenteeism amongst health workers--developing a typology to support empiric work in low-income countries and characterizing reported associations.

The contribution of inadequate health worker numbers and emigration have been highlighted in the international literature, but relatively little attention has been paid to absenteeism as a factor that undermines health-care delivery in low income countries. We therefore aimed to review the literature on absenteeism from a health system manager's perspective to inform needed work on this topic. Specifically, we aimed to develop a typology of definitions that might be useful to classify different forms of absenteeism and identify factors associated with absenteeism. Sixty-nine studies were reviewed, only four were from sub-Saharan Africa where the human resources for health crisis is most acute. Forms of absenteeism studied and methods used vary widely. No previous attempt to develop an overarching approach to classifying forms of absenteeism was identified. A typology based on key characteristics is proposed to fill this gap and considers absenteeism as defined by two key attributes, whether it is: planned/unplanned, and voluntary/involuntary. Factors reported to influence rates of absenteeism may be broadly classified into three thematic categories: workplace and content, personal and organizational and cultural factors. The literature presents an inconsistent picture of the effects of specific factors within these themes perhaps related to true contextual differences or inconsistent definitions of absenteeism.

[Sick-pay trends of the National Health Insurance Fund of Hungary between 1997 and 2017]. / Az Egészségbiztosítási Alap táppénzes trendjei Magyarországon 1997 és 2017 között.

INTRODUCTION: The role of sick-pay is to compensate for loss of wage in case of incapacity for work, to ensure that there will be no break in the existential state of the incapacitated person. AIM: The purpose of our research was to examine data on sickness benefit and payroll data for the period 1997-2017. DATA AND METHODS: Our research was based on the data of the National Health Insurance Fund of Hungary, the Hungarian Central Statistical Office, the State Audit Office of Hungary and the Hungarian State Treasury as well as on the background reports of the European Commission's Social Protection Committee and the Organisation for Economic Co-operation and Development (OECD), and it is based on the legal environment of sick-pay. RESULTS: In 1997, there were 119 000 of 3.558 million, in 1998 114 000 of 3.530 million, in 1999 115 000 of 3.433 million, in 2000 112 000 of 3.465 million, in 2006 100 000 of 3.523 million, in 2012 55 000 of 3.769 million entitled people on sick leave on average per day. In 2017, the number of entitled persons increased to 4.018 million, while the average number of sick days per day was 70 000. According to data from gender and age-based analysis, in most cases, women with childbearing were on sick-leave, the proportion of males was higher in relation to industrial accident. Between 2014 and 2016, the proportion of women on sick leave per day was 59-60%, while the major reason for sick-pay among men was the industrial accident. The distribution by age did not change significantly. In 2014-2015, the age-group 30-34, while in 2016 the age-group 35-39 had the highest utilization of sick-pay. CONCLUSION: We can conclude that the use of sick-pay is affected by the employment rate, legal changes affecting the amount of sick-pay and social trends like substitution difficulties due to labor shortages and fear of losing jobs. Orv Hetil. 2019; 160(Suppl 1): 37-42.

Incapacidad como acto médico y ley estatutaria de salud / The Inability as a Medical Act

Con el avance de la Seguridad Social en Salud en Colombia y la protección del derecho fundamental a la salud, se ha consolidado la autonomía médica con la expedición de la Ley Estatutaria de Salud, expedida en 2015. En el artículo se presentan conceptos inherentes a dicho ejercicio en Colombia y la actualización de un artículo publicado con anterioridad.

With the advancement of Social Security in Health in Colombia and the protection of the fundamental right to Health, medical autonomy is Consolidated with the Statutory Health Law issued in 2015. The arricie presents inherent concepts to this exercise in Colombia and the update of an arricie published previously.

Reincorporación al trabajo tras un episodio de incapacidad temporal por trastornos músculo-esqueléticos: revisión sistemática de guías de buenas prácticas / Return to work after musculoskeletal disorders; A systematic review of good practices guidelines

Objetivo: Identificar las guías disponibles en la literatura sobre retorno al trabajo después de un episodio de incapacidad temporal (IT) por trastornos músculo-esqueléticos (TME) y evaluar la calidad metodológica de las mismas. Métodos: Se realizó una búsqueda sistemática de guías específicas de retorno al trabajo en inglés, castellano y catalán cuyo contenido tenía en forma total o parcial información sobre TME. Las guías identificadas fueron evaluadas cualitativa y cuantitativamente por siete expertos utilizando el método validado AGREE II. Para cada dominio se calcularon tanto las puntuaciones estandarizadas como las medianas de las puntuaciones con las que los evaluadores habían calificado cada ítem. Además, cada evaluador hizo un juicio cualitativo de la calidad metodológica de la guía. Resultados: Se identificaron 32 guías, de estas seis fueron seleccionadas para evaluar su calidad metodológica (tres específicas para TME). Sólo dos guías, la Official Disability Guidelines (ODG) y la Work-related Musculoskeletal Disorders Guide &Tools (WRGT), podrían utilizarse en la práctica profesional sin necesidad de modificaciones en su metodología. En general, todas las guías definen bien sus objetivos y a quién van dirigidas; y las opciones de retorno al trabajo se presentan en forma precisa. Sin embargo, todas excepto una (ODG) tienen limitaciones en los criterios para seleccionar la evidencia científica y no se mencionan los potenciales conflictos de interés. Conclusiones: Sólo fueron identificadas dos guías con alta calidad metodológica. Sin embargo, sería recomendable una evaluación basada en la evidencia de la calidad de sus recomendaciones

Objective: To identify existing return-to-work (RTW) guidelines following a sickness absence (SA) due to musculoskeletal disorders (MSD) and evaluate their methodological quality. Methods: We performed a systematic search for RTW guideliness written in English, Spanish and Catalan, that included total or partial information on MSD. The identified guidelines were evaluated qualitatively and quantitatively by seven experts using the validated AGREE method. Standardized scores for each domain were calculated for each of the guidelines, as well as the median of the experts scores for each of the items. In addition, each expert made a subjective judgment on the quality of the selected guidelines. Results: Thirty-two guidelines were identified. From these, 6 (3 of which were MSD-specific) were selected for an evaluation of their methodological quality. Only two, the Official Disability Guidelines (ODG) and the Work-related Musculoskeletal Disorders Guide & Tools (WRGT) were felt to be suitable for use without further methodological modifications. In general, all of the guidelines properly define their objectives and target audience, and the RTW options are presented in a clear and precise way. However, all guides but one (ODG) have limitations in the criteria for selection of scientific evidence, and the potential conflicts of interest are not stated. Conclusions: Only two guides of high methodological quality were identified. However, an evidence-based evaluation of the quality of their recommendations is recommended prior to their use in professional practice

Trends in socioeconomic differences in sickness absence among Finnish municipal employees 1990-99.

AIMS: This study examined the associations of key dimensions of socioeconomic status and long sickness absence spells as well as their changes over time from 1990 to 1999. METHODS: Municipal employees of the City of Helsinki, Finland, aged 25-59 were studied. The number of participants varied yearly from 24,029 women and 6,523 men to 27,861 women and 7,521 men. Socioeconomic status was assessed by education, occupational class, and individual income. The outcome was the number of over three days' sickness absence spells/100 person years, for which the employer requires medical certification. RESULTS: Low education, occupational class, and individual income were consistently associated with a 2-3 times higher sickness absence rates among both men and women. The age-adjusted sickness absence rates were relatively stable from 1990 to 1994 but increased from 1994 to 1999 among men and women. Socioeconomic differences in sickness absence rates tended to increase. CONCLUSIONS: The increase in the level of socioeconomic differences in sickness absence took place during a period of declining unemployment and staff increases at the City of Helsinki, which indicates that labour market conditions play a role in sickness absence.

Modernization, globalization and the welfare state: a comparative analysis of old and new convergence of social insurance since 1930.

Convergence of policies and institutions across countries has been a recurrent theme within social sciences. 'Old' and 'new' convergence hypotheses have been associated with changing concepts and catchwords, such as modernization, logic of industrialism, post-industrialism, post-Fordism and globalization, but share some underlying theoretical perspectives. The purpose of this paper is to analyse tendencies towards convergence of social insurance systems in 18 OECD countries between 1930 and 1990, a period which has seen our sample of countries develop from predominantly agricultural societies to industrial or post-industrial market democracies. Data from the Social Citizenship Indicator Program (SCIP) are used to examine the development of institutional variables within the various national social insurance systems. Sub-samples of larger and smaller countries are examined separately, in order to test the open-economy hypothesis that smaller countries, being more exposed to international pressures than larger ones, could be expected to show higher degrees of social protection and also more convergence. Hypotheses on differentiated institutional barriers against pressures from the processes of transnationalization of the economy, as well as possible convergence effects of the supra-national policy making within the European Union, are discussed in the last section.

Tendencias actuales en el análisis económico de la morbilidad laboral / Presents trends in the economic analysis of occupational morbidity

Se evaluaron tendencias en el análisis de las pérdidas económicas por morbilidad laboral, considerándose los instrumentos utilizados, que se han desarrollado en 3 vertientes: modelos, métodos e indicadores. Se confiaron, que de los instrumentos estudiados, los indicadores son los que más se ajustan a las condiciones de la economía cubana, validados durante su aplicación experimental en diversos centros laborales del país. Se concluyó que son los instrumentos idóneos para evaluar el efecto económico de la morbilidad en los centros de trabajos estatales, considerando las condiciones propias de la economía cubana. Se proponen 2 nuevos indicadores(AU)