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1.
Am J Ind Med ; 64(2): 73-77, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33355943

RESUMO

Globally, migrant and immigrant workers have borne the brunt of the COVID-19 pandemic as essential workers. They might be a Bulgarian worker at a meat processing plant in Germany, a Central American farmworker in the fields of California, or a Filipino worker at an aged-care facility in Australia. What they have in common is they are all essential workers who have worked throughout the coronavirus pandemic and have been infected with coronavirus at work. COVID-19 has highlighted the inequitable working conditions of these workers. In many instances, they are employed precariously, and so are ineligible for sick leave or social security, or COVID-19 special payments. If these are essential workers, they should get at least the same health and safety benefits of all nonessential workers. Improving the working and living conditions of migrant workers can and should be a positive outcome of the coronavirus pandemic.


Assuntos
/epidemiologia , Doenças Profissionais/epidemiologia , Migrantes/estatística & dados numéricos , /transmissão , Estudos Transversais , Saúde Global/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Benefícios do Seguro/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Serviços de Saúde do Trabalhador/provisão & distribução , Fatores de Risco , Licença Médica/estatística & dados numéricos , Previdência Social/estatística & dados numéricos , Valores Sociais , Fatores Socioeconômicos
2.
Rev. adm. pública (Online) ; 54(6): 1729-1746, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1143901

RESUMO

Abstract Since 2016, the number of recipients of incapacity allowance in Brazil has been continuously falling. This article presents the program of incapacity benefits assessment (PRBI) to help understand the dynamics around incapacity allowance and similar benefits. The study shows that the PRBI can save more than R$ 85 billion of the budget allocated to social security in the country.


Resumen El número de beneficiarios de subsidios por incapacidad laboral ha disminuido drásticamente desde 2016. Este artículo muestra que el Programa para la Evaluación de Subsidios por Incapacidad Laboral (PRBI) es clave para entender esta dinámica y es responsable de una economía de más de R$ 85 mil millones para el Régimen General de Previsión Social de Brasil.


Resumo O número de benefícios de auxílio-doença vem caindo drasticamente desde 2016. Este artigo mostra que o Programa de Revisão dos Benefícios por Incapacidade (PRBI) é fundamental para entender essa dinâmica, e estima que o Programa seja responsável por uma economia de mais de R$ 85 bilhões ao Regime Geral de Previdência Social.


Assuntos
Humanos , Masculino , Feminino , Previdência Social/economia , Legislação , Despesas Públicas
3.
Nat Commun ; 11(1): 5150, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33051452

RESUMO

It is often assumed that incongruence between individuals' values and those of their country is distressing, but the evidence has been mixed. Across 29 countries, the present research investigated whether well-being is higher if people's values match with those of people living in the same country or region. Using representative samples, we find that person-country and person-region value congruence predict six well-being measures (e.g., emotional well-being, relationship support; N = 54,673). Crucially, however, value type moderates whether person-country fit is positively or negatively associated with well-being. People who value self-direction, stimulation, and hedonism more and live in countries and regions where people on average share these values report lower well-being. In contrast, people who value achievement, power, and security more and live in countries and regions where people on average share these values, report higher well-being. Additionally, we find that people who moderately value stimulation report the highest well-being.


Assuntos
Cultura , Valor da Vida , Emoções , Humanos , Percepção , Filosofia , Previdência Social
4.
Textos contextos (Porto Alegre) ; 19(1): 34207, 30 out. 2020.
Artigo em Português | LILACS | ID: biblio-1146830

RESUMO

Este trabalho examina, a partir dos dados fornecidos pelo Instituto Nacional do Seguro Social, a aposentadoria do trabalhador com deficiência no contexto contemporâneo de contrarreformas governamentais no âmbito da seguridade social brasileira. A deficiência é analisada, aqui, como resultado de uma produção da sociabilidade regida sob a lógica do capital em um país de capitalismo periférico e dependente: o Brasil. Este é marcado, ainda, pela superexploração do trabalho, o que resulta na intensificação dos mecanismos de extração da mais-valia e de políticas sociais cada vez mais agudizadas pela focalização e seletividade no mítico estado de direito burguês. As taxas negativas são superiores às de concessão do benefício, tão afinadas ao esperado pela burguesia rentista que busca ampliar a mercantilização dos serviços sociais


This work examines, based on data provided by the Brazilian National Institute of Social Security, the retirement of workers with disabilities in the contemporary context of government counter-reforms in the context of Brazilian social security. Disability is analyzed here as a result of a production of sociability governed by the logic of capital in a country of peripheral and dependent capitalism: Brazil. This is also marked by the overexploitation of labor, which results in the intensification of the mechanisms of surplus value extraction and of social policies increasingly exacerbated by the focus and selectivity in the mythical bourgeois state of law. The negative rates are higher than those for granting the benefit, so in tune with the expectations of the rentier bourgeoisie that it seeks to expand the commodification of social services


Assuntos
Aposentadoria , Previdência Social , Pessoas com Deficiência , Categorias de Trabalhadores
5.
BMC Public Health ; 20(1): 1443, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967646

RESUMO

BACKGROUND: Client-Centered Representative Payee (CCRP) is an intervention modifying implementation of a current policy of the US Social Security Administration, which appoints organizations to serve as financial payees on behalf of vulnerable individuals receiving Social Security benefits. By ensuring beneficiaries' bills are paid while supporting their self-determination, this structural intervention may mitigate the effects of economic disadvantage to improve housing and financial stability, enabling self-efficacy for health outcomes and improved antiretroviral therapy adherence. This randomized controlled trial will test the impact of CCRP on marginalized people living with HIV (PLWH). We hypothesize that helping participants to pay their rent and other bills on time will improve housing stability and decrease financial stress. METHODS: PLWH (n = 160) receiving services at community-based organizations will be randomly assigned to the CCRP intervention or the standard of care for 12 months. Fifty additional participants will be enrolled into a non-randomized ("choice") study allowing participant selection of the CCRP intervention or control. The primary outcome is HIV medication adherence, assessed via the CASE adherence index, viral load, and CD4 counts. Self-assessment data for ART adherence, housing instability, self-efficacy for health behaviors, financial stress, and retention in care will be collected at baseline, 3, 6, and 12 months. Viral load, CD4, and appointment adherence data will be collected at baseline, 6, 12, 18, and 24 months from medical records. Outcomes will be compared by treatment group in the randomized trial, in the non-randomized cohort, and in the combined cohort. Qualitative data will be collected from study participants, eligible non-participants, and providers to explore underlying mechanisms of adherence, subjective responses to the intervention, and implementation barriers and facilitators. DISCUSSION: The aim of this study is to determine if CCRP improves health outcomes for vulnerable PLWH. Study outcomes may provide information about supports needed to help economically fragile PLWH improve health outcomes and ultimately improve HIV health disparities. In addition, findings may help to refine service delivery including the provision of representative payee to this often-marginalized population. This protocol was prospectively registered on May 22, 2018 with ClinicalTrials.gov (NCT03561103) .


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Marginalização Social , Previdência Social/economia , Humanos , Projetos de Pesquisa , Estados Unidos , United States Social Security Administration
6.
Artigo em Inglês | MEDLINE | ID: mdl-32823833

RESUMO

The 2020 coronavirus pandemic has catapulted China into a serious social and political crisis. This article focuses upon how Chinese social policy has responded to the Covid-19 crisis. It reveals that the Chinese welfare state has woven a comprehensive social safety net to mitigate the social suffering of Chinese society in the mid- and post-crisis periods. Different types of social policy programs have been combined and synthesized, including social insurance, social assistance, and social welfare arrangements. Facing the challenges of the new risks caused by the pandemic, the collaboration of the Chinese state and intermediary social welfare organizations has played a crucial role in providing both cash benefits and social services (benefits in kind). For the first time, social policy in China has acted as a major player for coping with the negative outcomes of a pandemic. This article concludes that the pandemic-related crisis has justified an interventionist approach and logic, driven by the state's welfare system, which favors a model of "big government". However, this model also requires justification and legitimation.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Política Pública , China/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Pandemias , Pneumonia Viral/virologia , Previdência Social , Seguridade Social
7.
J. negat. no posit. results ; 5(7): 740-762, jul. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194132

RESUMO

La seguridad social es un derecho fundamental al que todos los miembros de una sociedad deberían tener acceso puesto que incluye un conjunto de beneficios vinculados a estabilidad económica, de salud y mejor calidad de vida, aunque aún es un reto para alcanzar la cobertura sanitaria universal. En el presente artículo se muestra una revisión de las condiciones socioeconómicas de México, asociadas a la seguridad social, en diversos procesos históricos: Porfiriato, Revolución Mexicana, Revolución pasiva, Proteccionismo, Neoliberalismo y Lopezobradorismo. En cada uno se identificaron aspectos políticos, financieros y sociales relacionados con la mejora o estancamiento de la seguridad social. Estos hallazgos reflejan la importancia de reflexionar de manera propositiva sobre las variables socioeconómicas para comprender el éxito o fracaso de las políticas públicas y los resultados negativos para la salud de la población


The social security is a fundamental right which all society members should have access because includes a set of benefits linked to economic and health stability and better quality of life, although it's still a challenge to achieving universal health coverage. This article presents a review of socioeconomic conditions from Mexico associated to social security in various historical processes: Porfiriato, Mexican Revolution, Passive revolution, Protectionism, Neoliberalism and Lopezobradorismo. Political, financial and social aspects were identified in each of these and that were associated to the improvement or stagnation of social security. These findings reflect the importance of analyzing proactively about the socioeconomic variables to understanding the success or failure of public politics and their negative results for the population health


Assuntos
Humanos , História do Século XX , Previdência Social/história , Organização do Financiamento/história , Planejamento Socioeconômico/história , México , Política Financeira , Políticas Públicas de Saúde , Seguridade Social/história , Educação Médica/história
8.
Artigo em Inglês | MEDLINE | ID: mdl-32503137

RESUMO

Vocational rehabilitation (VR) aims at improving work ability to facilitate workers' return to work. VR is provided in Brazil by the public social security system. The aim of the present study was to analyze trends in VR indicators for Brazil from 2007 to 2016. Based on open-access, secondary aggregate data, we calculated the cumulative incidence of VR indicators. We fitted Prais-Winsten generalized linear regression models to estimate trends and calculated annual percent variation with the corresponding 95% confidence interval (95% CI). The mean cumulative incidence of referrals to VR services was 37.16/1000 temporary disability benefits granted and exhibited a decreasing trend of -6.92% (95% CI: -8.38; -5.43). The mean cumulative incidence of admissions to VR services was 57.34/100 referrals and exhibited an increasing trend of 3.31% (95% CI: 1.13; 5.53). The mean cumulative incidence of rehabilitation was 57.43/100 admissions and remained stable along the analyzed period, -2.84 (95% CI: -5.87; 0.29). Our findings evidence a reduction in the number of workers referred for VR, an increase of admissions, and stability in the cumulative incidence of rehabilitated workers.


Assuntos
Pessoas com Deficiência , Reabilitação Vocacional , Brasil , Humanos , Incidência , Previdência Social
9.
J Aging Soc Policy ; 32(4-5): 488-498, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32538320

RESUMO

The COVID-19 economic crisis makes it vitally important that workers who earned defined benefit pensions receive them at retirement. Unfortunately, billions of dollars that could help cushion the financial shock are sitting unclaimed, because the people who they belong to cannot locate the company responsible for paying them. As defined benefit pension plans have been terminated, merged and moved over the years, large numbers of deferred vested participants have not been notified about their benefits. The widespread and growing practice of insurance company pension buy-outs can be especially problematic for participants without notice. Broader use of electronic disclosures for pensions also threatens to make the situation worse. In the wake of COVID-19, policy makers should take steps to ensure that pension benefits are part of the economic recovery.


Assuntos
Infecções por Coronavirus/epidemiologia , Pensões/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Aposentadoria/economia , Betacoronavirus , Recessão Econômica/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Pandemias , Previdência Social/organização & administração , Estados Unidos/epidemiologia
10.
J Oral Sci ; 62(3): 348-349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32581182

RESUMO

In this aging Japanese society, the demand for ensuring a healthy life and improving the quality of life is on the rise. The government declared "Health Japan 21" and dental health has been identified as one of the most important issues. At the same time, national medical care expenditure is increasing year by year. As such, efficiency in dentistry is required, and the quality, efficacy, and safety of medical devices have been standardized. As one of the steps toward introducing new medical devices and technology, this report contains a collection of data, research, and studies on the social insurance system and pricing of medical devices in foreign countries.


Assuntos
Qualidade de Vida , Previdência Social , Japão
11.
BMJ Glob Health ; 5(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32540963

RESUMO

The COVID-19 pandemic is a reminder that insufficient income security in periods of ill health leads to economic hardship for individuals and hampers disease control efforts as people struggle to stay home when sick or advised to observe quarantine. Evidence on income security during periods of ill health is growing but has not previously been reviewed as a full body of work concerning low-income and middle-income countries (LMICs). We performed a scoping review to map the range, features, coverage, protective effects and equity of policies that aim to provide income security for adults whose ill health prevents them from participating in gainful work. A total of 134 studies were included, providing data from 95% of LMICs. However, data across the majority of these countries were severely limited. Collectively the included studies demonstrate that coverage of contributory income-security schemes is low, especially for informal and low-income workers. Meanwhile, non-contributory schemes targeting low-income groups are often not explicitly designed to provide income support in periods of ill health, they can be difficult to access and rarely provide sufficient income support to cover the needs of eligible recipients. While identifying an urgent need for more research on illness-related income security in LMICs, this review concludes that scaling up and diversifying the range of income security interventions is crucial for improving coverage and equity. To achieve these outcomes, illness-related income protection must receive greater recognition in health policy and health financing circles, expanding our understanding of financial hardship beyond direct medical costs.


Assuntos
Acesso aos Serviços de Saúde , Renda , Pobreza , Previdência Social , Adulto , Betacoronavirus , Infecções por Coronavirus , Países em Desenvolvimento , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Pandemias , Pneumonia Viral , Licença Médica , Previdência Social/economia , Previdência Social/legislação & jurisprudência
12.
J Aging Soc Policy ; 32(4-5): 477-487, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32543304

RESUMO

The COVID-19 pandemic has impacted communities throughout the United States and worldwide. While the implications of the concomitant economic downturn for older adults are just beginning to be recognized, past experience suggests that the consequences could be devastating for many. Analyses indicate that more than one out of five Americans aged 65 years or older live in counties where high infection rates and high economic insecurity risks occur simultaneously. These findings highlight the overlap between current infection patterns and subsequent challenges to economic security that are impacting older people. Strategies and supports for getting people back to work must take into account the large segment of older people who rely on earnings well into later life. Social Security serves as the foundation of economic security for older adults across the income continuum, but it is frequently insufficient in and of itself, let alone during a crisis. Recognizing the importance of cost of living in shaping economic security highlights the need for the federal and state governments and municipalities to take older people into account in the economic recovery effort.


Assuntos
Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Renda/estatística & dados numéricos , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Recessão Econômica/estatística & dados numéricos , Humanos , Previdência Social/estatística & dados numéricos , Fatores Socioeconômicos , Estados Unidos/epidemiologia
14.
BMC Public Health ; 20(1): 614, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32366310

RESUMO

BACKGROUND: Social Health Insurance (SHI) is widely used by countries attempting to move toward Universal Health Coverage (UHC). While evidence suggests that SHI is a promising strategy for achieving UHC, low-income countries often struggle to implement and sustain SHI systems. It is therefore important to understand how SHI enrollees use health insurance and how it affects their health-seeking behavior. This paper examines how SHI affects patient decision-making regarding when and where to seek care in Kenya and Ghana, two countries with established SHI systems in sub-Saharan Africa. METHODS: This paper draws from two datasets collected under the African Health Markets for Equity (AHME) program. One dataset, collected in 2013 and 2017 as part of the AHME qualitative evaluation, consists of 106 semi-structured clinic exit interviews conducted with patients in Ghana and Kenya. This data was analyzed using an inductive, thematic approach. The second dataset was collected internally by the AHME partner organizations. It derives from a cross-sectional survey of social franchise clients at three social franchise networks supported by AHME. Data collection took place from February - May 2018 and in December 2018. RESULTS: Many clients appreciated that insurance coverage made healthcare more affordable, reported seeking care more frequently when covered with SHI. Clients also noted that the coverage gave them access to a wider variety of providers, but rarely sought out SHI-accredited providers specifically. However, clients sometimes were charged for services that should have been covered by insurance. Due to a lack of understanding of SHI benefits, clients rarely knew they had been charged inappropriately. CONCLUSIONS: Clients and providers would benefit from education on what is included in the SHI package. Providers should be monitored and held accountable for charging clients inappropriately; in Ghana this should be accompanied by reforms to make government financing for SHI sustainable. Since clients valued provider proximity and both Kenya and Ghana have a dearth of providers in rural areas, both countries should incentivize providers to work in these areas and prioritize accrediting rural facilities into SHI schemes to increase accessibility and reach.


Assuntos
Assistência à Saúde/economia , Assistência à Saúde/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Previdência Social/estatística & dados numéricos , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Gana , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Lancet Glob Health ; 8(6): e840-e849, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32446349

RESUMO

BACKGROUND: Multimorbidity, the presence of two or more mental or physical chronic non-communicable diseases, is a major challenge for the health system in China, which faces unprecedented ageing of its population. Here we examined the distribution of physical multimorbidity in relation to socioeconomic status; the association between physical multimorbidity, health-care service use, and catastrophic health expenditures; and whether these associations varied by socioeconomic group and social health insurance schemes. METHODS: In this population-based, panel data analysis, we used data from three waves of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) for 2011, 2013, and 2015. We included participants aged 50 years and older in 2015, who had complete follow-up for the three waves. We used 11 physical non-communicable diseases to measure physical multimorbidity and annual per-capita household consumption spending as a proxy for socioeconomic status. FINDINGS: Of 17 708 participants in CHARLS, 11 817 were eligible for inclusion in our analysis. The median age of participants was 62 years (IQR 56-69) in 2015, and 5766 (48·8%) participants were male. 7320 (61·9%) eligible participants had physical multimorbidity in China in 2015. The prevalence of physical multimorbidity was increased with older age (odds ratio 2·93, 95% CI 2·71-3·15), among women (2·70, 2·04-3·57), within a higher socioeconomic group (for quartile 4 [highest group] 1·50, 1·24-1·82), and higher educational level (5·17, 3·02-8·83); however, physical multimorbidity was more common in poorer regions than in the more affluent regions. An additional chronic non-communicable disease was associated with an increase in the number of outpatient visits (incidence rate ratio 1·29, 95% CI 1·27-1·31), and number of days spent in hospital as an inpatient (1·38, 1·35-1·41). We saw similar effects in health service use of an additional chronic non-communicable disease in different socioeconomic groups and among those covered by different social health insurance programmes. Overall, physical multimorbidity was associated with a significantly increased likelihood of catastrophic health expenditure (for the overall population: odds ratio 1·29, 95% CI 1·26-1·32, adjusted for sociodemographic variables). The effect of physical multimorbidity on catastrophic health expenditures persisted even among the higher socioeconomic groups and across all health insurance programmes. INTERPRETATION: Concerted efforts are needed to reduce health inequalities that are due to physical multimorbidity, and its adverse economic effect in population groups in China. Social health insurance reforms must place emphasis on reducing out-of-pocket spending for patients with multimorbidity to provide greater financial risk protection. FUNDING: None.


Assuntos
Doença Catastrófica/economia , Utilização de Instalações e Serviços/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Multimorbidade , Doenças não Transmissíveis , Classe Social , Idoso , China/epidemiologia , Feminino , Humanos , Seguro Saúde , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/economia , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/terapia , Prevalência , Previdência Social
16.
Am J Obstet Gynecol ; 223(3): 379.e1-379.e5, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32446998

RESUMO

For the last century, healthcare coverage in the United States has been a debated topic. The passage of the Social Security Act Amendments and the Patient Protection and Affordable Care Act has improved the available coverage of vulnerable populations, but access to healthcare is still fraught with barriers. This is particularly true for women in the postpartum period. It is widely accepted that the postpartum period is the optimal time to address health issues that developed during pregnancy or predated pregnancy. With more than half of maternal deaths occurring in the year after a birth and disproportionately affecting women of color, the postpartum time period is critical. The United States is the only industrialized country with a rising maternal mortality rate and therefore must take advantage of the 12 months postpartum, or "fourth trimester," to aid in addressing this national health crisis. As an incentivized provision, most states have expanded Medicaid since the signing of the Patient Protection and Affordable Care Act. However, pregnancy-related coverage still ceases after 60 days postpartum. Although states can apply for a waiver to extend this coverage, this process is unnecessarily laborious. The time has far passed for the federal government to act. Presently, there are numerous pieces of legislation before Congress to provide Medicaid coverage for pregnant patients through 365 days postpartum. Insurance coverage alone will not reverse the rising maternal mortality rate in this country, but it is a crucial first step.


Assuntos
Cobertura do Seguro/legislação & jurisprudência , Medicaid/legislação & jurisprudência , Cuidado Pós-Natal/economia , Feminino , Humanos , Morte Materna/prevenção & controle , Período Pós-Parto , Gravidez , Previdência Social/legislação & jurisprudência , Fatores de Tempo , Estados Unidos
17.
BMC Public Health ; 20(1): 477, 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32276612

RESUMO

BACKGROUND: Chronic venous disease (CVD) and disability are worldwide problems and have significant socioeconomic implications. This study aims to analyze the time trends and social security burden of temporary work disability due to CVD in Brazil. METHODS: An ecological time series study using the Brazilian Social Security System database was performed from 2005 to 2014. Data from all benefits granted to workers with temporary disability due to CVD were analyzed. The cases were identified using diagnosis codes I83-I83.9 of the International Classification of Diseases 10th Revision (ICD-10). The time trend analyses were performed by the Joinpoint Regression Model, with sex, age, regions, income, and category of affiliation as variables. Crude and age-standardized rates were calculated. RESULTS: A total of 429,438 benefits were granted for temporary work disability due to CVD from 2005 to 2014, with a growing trend and an age-standardized annual percent change (APC) of 3.4 (95% CI: 2.6-4.2) (p < 0.05). Social security expense increased 3.5-fold, and the number of days in benefit doubled from 2005 to 2014. In total, 27,017,818 working days were lost. The average duration of benefits was 55.3 days. The majority of workers were women (68.2%) (p < 0.001), between 30 and 59 years old, employed, had a monthly income ≤2 minimum wages (MW) (83.2%), and lived in the regions southeast (53.6%) and south (29.3%). Significantly higher APCs were observed for women than for men (APC: 4.9, 95% CI: 4.0-5.7 versus APC: 1.2, 95% CI: 0.1-2.4). All regions in Brazil had a significant growing trend, except in the north. No significant growth was observed in the age group of 60-69 years. A decreasing trend was observed in workers with monthly incomes above 2 MW (p < 0.05). CONCLUSIONS: Temporary work disability due to CVD and social security burden showed increasing trends with millions of working days lost, particularly among women and low-income workers. Preventing disability is challenging, and public policies are needed to reduce the social and economic impact of disability. Therefore, measures for promoting health at the workplace should be encouraged.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Previdência Social/economia , Doenças Vasculares/economia , Doenças Vasculares/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Doença Crônica , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-32110896

RESUMO

China's Serious Disease Insurance Scheme (SDIS) was set up to relieve the financial burdens on serious disease patients. It is a crucial part of the national basic medical insurance scheme, which is regarded as one of the largest government-funded social security programs in the world. The most significant institutional innovation of the SDIS is that the approach of a public-private partnership (PPP) is applied in an attempt to facilitate the efficiency of its implementation. The objective of this paper is to evaluate the implementation of the SDIS in China through PPPs, and to identify the problems to be tackled if the Chinese government intends to make such a plan work better for the majority of urban and rural residents. With the effective support from local officials and practitioners, the authors of this paper collected copies of SDIS contracts of multiple cities in Guangdong, one of the most developed provinces of China. Guided by a research framework drawn from the PPP literature, details of contract enforcement were also examined. The authors discovered that the role of local states is rather dominant; they have manipulated contract drafting and implementation. Additionally, current mechanisms for profit sharing, risk sharing, and information exchange have placed insurance companies in a rather disadvantageous situation. To achieve the sustainable development of the SDIS, the authors suggest that a further reform on implementation of a PPP must be pushed forward.


Assuntos
Reforma dos Serviços de Saúde , Seguro Saúde , Parcerias Público-Privadas , População Rural , China , Reforma dos Serviços de Saúde/economia , Humanos , Seguro Saúde/economia , Previdência Social
20.
Int J Equity Health ; 19(1): 33, 2020 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164725

RESUMO

BACKGROUND: In Nigeria, health maintenance organizations (HMOs) are the purchasers of health insurance with a social National Health Insurance Scheme for civil servants. However the roles of HMOs in implementation of social health insurance are not clear. This study determined the roles of HMOs in implementation of the national social health insurance scheme in Enugu, Southeast Nigeria. METHODS: A partially mixed sequential dominant status design was employed in the study. Quantitative data were collected from 613 Federal Government employees that are registered with the National Health Insurance Scheme (NHIS) as part of the Formal Sector Social Health Insurance Program (FSSHIP) using an interviewer-administered questionnaire. Test for sampling adequacy was ensured (KMO, 0.701) and likewise the sphericity of the data using Bartlett's test (Chi [1] 796.72, p-value < 0.001). For the qualitative study, there was document review and in-depth interviews. A total of 28 in-depth interviews were conducted with key stakeholders comprising of managers of HMOs, NHIS manager, providers of health care and personnel in the State Ministry of Health among others. Thematic analysis was used for the qualitative data. RESULTS: One-third (31.5%) of respondents said that roles of HMOs were very important, while 23% said that their roles were not important. More than half (57.70%) ranked HMOs very low in their roles, while 24.10% ranked them highest. Concentration index shows that the poor were satisfied (-.10), while the rich were highly satisfied (0.13) with roles of HMOs. The qualitative data analysis showed that most of the respondents were not satisfied with the roles of HMOs based on the themes that were developed and analyzed. CONCLUSION: There is clear understanding of the functions of HMOs among respondents in the study although they generally think that HMOs are not meeting the expectations of the scheme. There is need for the Federal Government through the National Health Insurance Scheme to provide more effective guidelines for HMOs, supervise and monitor the implementation of such guidelines for HMOs to improve on their roles.


Assuntos
Atitude , Sistemas Pré-Pagos de Saúde , Programas Nacionais de Saúde , Assistência à Saúde , Feminino , Promoção da Saúde , Humanos , Seguro Saúde , Nigéria , Satisfação Pessoal , Pobreza , Pesquisa Qualitativa , Classe Social , Previdência Social , Participação dos Interessados
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