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1.
Artigo em Inglês | MEDLINE | ID: mdl-36078796

RESUMO

The willingness of farmers to transfer land on a big scale will be impacted when the rural social security system is not ideal, which will limit households' productive investment. This paper investigated the intermediate effects of social security on farmland transfer and productive investment by using zero-inflated models based on 4703 samples across China. Here are the findings: (1) Farmland transfer does not significantly impact productive investment without considering social society. (2) With the improvement in social security, farmland transfer significantly affects fixed investment but is not the same as households' current investment. (3) Under the social security constraints, there is an inverted U-shaped relationship between farmland transfer and current investment. (4) The partial effect of farmland transfer on fixed investment is significantly positive, and it shows a trend of rising volatility. The government should re-examine the expected effects of the farmland transfer policy and focus on the farmers' worries about the future. Meanwhile, it is necessary to comprehensively improve the social security system and improve the multi-dimensional survival ability of farmers to give full play to the critical role of farmland transfer in current investment.


Assuntos
Fazendeiros , Previdência Social , Agricultura , China , Fazendas , Humanos , Renda
2.
Cien Saude Colet ; 27(10): 4039-4050, 2022 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-36134809

RESUMO

The aim of this study was to assess temporal trends in disability benefits for breast cancer awarded to women by Brazil's National Social Security Institute. We conducted a time-series analysis of disability benefit incidence rates between 2007 and 2018 using joinpoint regression and data from the Unified Benefits Information System (SUIBE) and open access social security system database. The age-adjusted incidence rate increased by 6.7% per year between 2015 and 2018 after a period of stability between 2007 and 2014. The number of benefits granted to women aged 20-49 increased, on average, by 3.4% per year, showing a marked rise from 2015 to 2018 (10.4% per year). The findings highlight that breast cancer is an important cause of sick leave among female workers and that the incidence of the disease is growing in younger economically active women, reinforcing the importance of early referral to the Social Security Professional Rehabilitation Program to help workers return to work and readapt to working life.


O objetivo deste estudo foi avaliar a tendência temporal dos benefícios previdenciários concedidos pelo Instituto Nacional do Seguro Social a mulheres por câncer de mama. Foi realizado um estudo de tendência temporal das taxas de incidência dos auxílios por incapacidade temporária de espécie previdenciária concedidos por câncer de mama em mulheres entre 2007 e 2018 no Brasil, utilizando o Sistema Único de Informações de Benefícios e a base de dados abertos da Previdência Social. As análises de tendência foram realizadas através de regressão segmentada joinpoint. As taxas de incidência dos benefícios ajustadas por idade apresentaram estabilidade entre 2007 e 2015, seguida de elevação anual de 6,7% de 2015 a 2018. Houve aumento anual médio de 3,4% do número de benefícios concedidos a mulheres entre 20 e 49 anos, sendo mais evidente entre 2015 e 2018, com elevação de 10,4% ao ano. Este estudo demonstrou a importância do câncer de mama como causa de afastamento do trabalho em mulheres, com acometimento crescente das faixas etárias mais jovens e economicamente ativas, o que reforça a necessidade de abordagem precoce do Programa de Reabilitação Profissional da Previdência Social para a readaptação destas trabalhadoras em suas atividades ou a reinserção no mercado de trabalho.


Assuntos
Neoplasias da Mama , Pessoas com Deficiência , Brasil/epidemiologia , Neoplasias da Mama/epidemiologia , Feminino , Humanos , Licença Médica , Previdência Social
3.
Arthritis Res Ther ; 24(1): 202, 2022 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-35996193

RESUMO

OBJECTIVE: To compare cardiovascular disease (CVD) rates in rheumatoid arthritis (RA) beneficiaries of the Social Security Disability Insurance (SSDI) with commercially insured RA patients. METHOD: We created three cohorts of RA patients aged < 65 years for SSDI and three for Marketscan using claims data from 2006 to 2016. The cohort definitions were as follows: (1) cohort 1: ≥ 2 diagnosis codes for RA occurring 7-365 days apart with ≥ 1 diagnosis code from a rheumatologist; (2) cohort 2: ≥ 1 diagnosis code for RA from a rheumatologist and a disease-modifying antirheumatic drugs (DMARDS); and (3) cohort 3: cohort 2, plus initiation of a new biologic/tofacitinib. We used Cox regression to determine the CVD risk comparing SSDI vs. Marketscan. Models were sequentially adjusted for age and sex (model 1); model 1 + diabetes, smoking, and high CVD risk (model 2); and model 2 + dual eligible (Medicare and Medicaid), subsidy, and state buy in (model 3). RESULTS: There were 380,336 RA patients, mean age 53.3 (SD 8.1) years, 21-24% male. Prevalence of comorbidities was higher in SSDI vs. Marketscan. SSDI RA patients in cohort 2 (model 3) had higher CVD risk (HR 1.23 (1.14-1.33). In cohort 3 (model 3), CVD risk was not statistically significantly different between SSDI and Marketscan (HR 0.89 (0.69-1.15). CONCLUSION: RA patient beneficiaries of the SSDI had higher risk for CVD events than those employed. The differences in CVD events between SSDI and Marketscan were partially attributable to differences in CVD risk factors.


Assuntos
Antirreumáticos , Artrite Reumatoide , Produtos Biológicos , Doenças Cardiovasculares , Seguro por Invalidez , Idoso , Antirreumáticos/uso terapêutico , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/epidemiologia , Produtos Biológicos/uso terapêutico , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Medicare , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Previdência Social , Estados Unidos/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-36011912

RESUMO

Welfare recipients were often considered the least deserving of COVID-related support. Despite the recent attention paid to the impact of COVID-19 pandemic on mental health, few studies have explored the mental distress experienced by welfare recipients. This cross-sectional study on female Comprehensive Social Security Allowance recipients in Hong Kong aimed to explore their level of mental distress and its association with a range of risk factors specific to welfare recipients. Hence, 316 valid cases from a local community center responded to our online survey. We found that 52.3%, 23.4%, and 78% of the participants showed moderate to extremely severe depression, anxiety, and stress symptoms, respectively. A higher level of mental distress was associated with having a psychiatric diagnosis, poorer social, and greater concerns over disciplining children, the living environment, daily expenses and being infected by COVID-19. Unexpectedly, being married, having a permanent residence, and having a job were not significant protective factors for this group. The models explained 45.5%, 44.6%, and 52.5% of the overall variance in the level of depression, anxiety, and stress (p < 0.01), respectively. Our findings have important implications for supporting female welfare recipients during a public health crisis and may help frontline staff and professionals provide prompt assistance to this group in need.


Assuntos
COVID-19 , Transtornos Mentais , Ansiedade/epidemiologia , Ansiedade/etiologia , COVID-19/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Feminino , Hong Kong/epidemiologia , Humanos , Transtornos Mentais/epidemiologia , Pandemias , SARS-CoV-2 , Previdência Social
5.
BMJ Open ; 12(8): e060551, 2022 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-35998949

RESUMO

OBJECTIVES: To evaluate the benefit distribution of social health insurance among domestic migrants in China. DESIGN: A national cross-sectional survey. SETTING: 348 cities from 32 provincial units in China. PARTICIPANTS: 1165 domestic migrants who used inpatient care services in the city of a new residence and had social health insurance. PRIMARY AND SECONDARY OUTCOME MEASURES: The probability of receiving reimbursements from social health insurance, the amounts and ratio of reimbursement received. RESULTS: Among migrants who used inpatient care in 2013, only 67% received reimbursements from social health insurance, and the reimbursement amount only accounted for 47% of the inpatient care expenditure. The broader the geographical scope of migration, the lower the probability of receiving reimbursement and the reimbursement ratio, but the higher the reimbursement amount. Specifically, the probability of receiving reimbursements for those who migrated across cities or provinces was significantly lower by 14.7% or 26.0%, respectively, than those who migrated within a city. However, they received significantly higher reimbursement amounts by 33.4% or 27.2%, respectively, than those who migrated within a city. And those who migrated across provinces had the lowest reimbursement ratio, although not reaching significance level. CONCLUSIONS: The unequal benefit distribution among domestic migrants may be attributed to the fragmented health insurance design that relies on localised administration, and later reimbursement approach that migrating patients pay for health services up-front and get reimbursement later from health insurance. To improve the equity in social health insurance benefits, China has been promoting the portability of social health insurance, immediate reimbursement for inpatient care used across regions, and a more integrated health insurance system. Efforts should also be made to control inflation of healthcare expenditures and prevent inverse government subsidies from out-migration regions to in-migration regions. This study has policy implications for China and other low/middle-income countries that experience rapid urbanisation and domestic migration.


Assuntos
Benefícios do Seguro , Seguro Saúde , China , Estudos Transversais , Humanos , Previdência Social
6.
Cir Cir ; 90(S1): 31-37, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35944102

RESUMO

INTRODUCTION: Data on hepatopancreatobiliary (HPB) surgery and COVID-19 are scarce. The objective of the study was to determine the outcomes HPB procedures during the COVID-19 pandemic and compare results to the previous year. METHODS: IRB approved study of HPB procedures (April, 2020-November, 2020). Primary endpoints: Thirty-day surgical morbidity/mortality, including COVID-19 infection. Secondary endpoints: Comparison between 2019 and 2020 procedures. RESULTS: Twenty-five patients were included. In 2020, HPB procedures decreased 31.6%. About 60% developed complications (Clavien-Dindo Grade III, 20%). Three patients developed post-operative COVID-19 infection (two deaths: 66% COVID-19 mortality). When compared to the previous year, there were more emergency cases, ventilator-assisted patients (p < 0.05) and pre-operative acute renal failure (p = 0.06). Clavien-Dindo complication grades were higher in 2020. Thirty-day mortality was also higher (16% vs. 5.6%). CONCLUSION: HPB surgical activity was negatively influenced by COVID-19 on 30-day morbidity/mortality. HPB patients who developed post-operative COVID-19 infection had a complicated course with significant mortality.


OBJETIVO: Los datos sobre cirugía hepatopancreatobiliar (HPB) y COVID-19 son escasos. El objetivo del estudio fue determinar los resultados de procedimientos de HPB durante la pandemia COVID-19 y comparar resultados con el año anterior. MATERIAL-MÉTODOS: Estudio de procedimientos HPB aprobado por el IRB (04/2020-11/2020). Criterios de valoración principales: morbilidad/mortalidad quirúrgica a los 30 días, incluida la infección por COVID-19. Criterios de valoración secundarios: comparación entre los procedimientos de 2019 y 2020. RESULTADOS: Se incluyeron 25 pacientes. En 2020, los procedimientos de HPB disminuyeron 31.6%. El 60% desarrolló complicaciones (grado III de Clavien-Dindo, 20%). 3 pacientes desarrollaron infección posoperatoria por COVID-19, (2 muertes: 66% de mortalidad por COVID-19). En comparación con el año anterior, hubo más casos de emergencia, pacientes asistidos por ventilador (p < 0.05) e insuficiencia renal aguda preoperatoria (p = 0.06). Los grados de complicación de Clavien-Dindo fueron más altos en 2020. La mortalidad a 30 días también fue más alta (16% frente a 5.6%). CONCLUSIÓN: La actividad quirúrgica de HPB fue influenciada negativamente por COVID-19 en la morbilidad/mortalidad a 30 días. Los pacientes con HPB que desarrollaron infección posoperatoria por COVID-19 tuvieron un curso complicado con una mortalidad significativa.


Assuntos
COVID-19 , Procedimentos Cirúrgicos do Sistema Digestório , COVID-19/epidemiologia , Hospitais , Humanos , Pandemias , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Previdência Social
7.
Multimedia | Recursos Multimídia | ID: multimedia-9775

RESUMO

En este webinar los expertos analizarán el impacto de la pandemia del COVID-19 en la Seguridad Social. Durante este seminario se dará una mirada al sistema de pensiones y riesgos laborales y se analizarán los retos actuales y su impacto en la nueva realidad que vive República Dominicana.


Assuntos
COVID-19 , República Dominicana , Previdência Social
8.
Health Policy ; 126(9): 925-932, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35817628

RESUMO

Despite mandatory social health insurance in Korea, the fraction of total healthcare spending paid out-of-pocket has been considerably high. In 2013, the Korean government expanded benefits coverage of social insurance for patients diagnosed with the costliest disease groups (cardiovascular and cerebrovascular diseases, cancer, and intractable diseases). We analyze individual longitudinal information from the 2010 to 2016 Korea Health Panel to estimate the impact of the policy change on healthcare spending, utilization, and enrollment in private supplemental health insurance. Impacts on other health-related and financial measures are additionally assessed to evaluate the effects in multiple dimensions. Our difference-in-differences approach with entropy balancing weights shows that the expansion of benefits coverage of public health insurance reduced out-of-pocket spending on health by 30% without accompanying increases in healthcare utilization. The impact was smaller for the individuals with high socioeconomic characteristics, who are more likely to use other costly services that remained unaffected by the policy. We do not find evidence that expanding social insurance benefits coverage changed the demand for supplemental private health insurance.


Assuntos
Seguro Saúde , Previdência Social , Atenção à Saúde , Gastos em Saúde , Humanos , Cobertura do Seguro , República da Coreia
9.
Artigo em Inglês | MEDLINE | ID: mdl-35886509

RESUMO

Individuals with substance abuse disorders experience trouble with the return to work or finding a stable workplace. At the same time, unemployment has negative effects on substance abuse. Work-related case management programs are often used to support the return to work in individuals with substance abuse disorders. This paper describes the experiences, perceived barriers, and facilitators, and their possible relations of people participating in a 12 month case management in Germany to support the return to work and to stabilize their workplace. For this purpose n = 15 interviews with the case management participants were conducted between December 2020 and September 2021. Data analysis followed a content analysis. The category system emerged is based on both the literature and the interview data. We describe several barriers and facilitators such as work motivation, experience with the case manager, and experience with the social security system. Furthermore, possible relationships between different barriers and facilitators are described. It will further be described how facilitators, especially the case manager, can help to overcome barriers, and how this might affect the intervention outcome.


Assuntos
Administração de Caso , Transtornos Relacionados ao Uso de Substâncias , Humanos , Pesquisa Qualitativa , Previdência Social , Transtornos Relacionados ao Uso de Substâncias/terapia , Desemprego , Local de Trabalho
10.
Artigo em Inglês | MEDLINE | ID: mdl-35897379

RESUMO

Health needs assessment is a relevant tracer of planning process of healthcare programs. The objective is to assess the health needs of chronic kidney disease (CKD) secondary to type 2 diabetes mellitus (T2 DM) in a population without social security in Mexico. The study design was a statistical simulation model based on data at the national level of Mexico. A stochastic Markov model was used to simulate the progression from diabetes to CKD. The time horizon was 16 years. The results indicate that in 2022, kidney damage progression and affectation in the diabetic patient cohort will be 34.15% based on the time since T2 DM diagnosis. At the end of the 16-year period, assuming that the model of care remains unchanged, early renal involvement will affect slightly more than twice as many patients (118%) and cases with macroalbuminuria will triple (228%). The need for renal replacement therapy will more than double (169%). Meanwhile, deaths associated with cardiovascular risk will more than triple (284%). We concluded that the clinical manifestations of patients with CKD secondary to T2 DM without social security constitute a double challenge. The first refers to the fact that the greatest health need is early care of CKD, and the second is the urgent need to address cardiovascular risk in order to reduce deaths in the population at risk.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Mellitus , Insuficiência Renal Crônica , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , México/epidemiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/etiologia , Fatores de Risco , Previdência Social
11.
Med Care ; 60(9): 655-664, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35880776

RESUMO

BACKGROUND: Identifying the most frequently treated and the costliest health conditions is essential for prioritizing actions to improve the resilience of health systems. OBJECTIVES: Healthcare Expenditures and Conditions Mapping describes the annual economic burden of 58 health conditions to prepare the French Social Security Funding Act and the Public Health Act. DESIGN: Annual cross-sectional study (2015-2019) based on the French national health database. SUBJECTS: National health insurance beneficiaries (97% of the French residents). MEASURES: All individual health care expenditures reimbursed by the national health insurance were attributed to 58 health conditions (treated diseases, chronic treatments, and episodes of care) identified by using algorithms based on available medical information (diagnosis coded during hospital stays, long-term diseases, and specific drugs). RESULTS: In 2019, €167.0 billion were reimbursed to 66.3 million people (52% women, median age: 42 y). The most prevalent treated diseases were diabetes (6.0%), chronic respiratory diseases (5.5%), and coronary diseases (3.2%). Coronary diseases accounted for 4.6% of expenditures, neurotic and mood disorders 3.7%, psychotic disorders 2.8%, and breast cancer 2.1%. Between 2015 and 2019, the expenditures increased primarily for diabetes (+€906 million) and neurotic and mood disorders (+€861 million) due to the growing number of patients. "Active lung cancer" (+€797 million) represented the highest relative increase (+54%) due to expenditures for the expensive drugs and medical devices delivered at hospital. CONCLUSIONS: These results have provided policy-makers, evaluators, and public health specialists with key insights into identifying health priorities and a better understanding of trends in health care expenditures in France.


Assuntos
Diabetes Mellitus , Gastos em Saúde , Adulto , Efeitos Psicossociais da Doença , Estudos Transversais , Diabetes Mellitus/terapia , Feminino , Estresse Financeiro , França , Humanos , Masculino , Programas Nacionais de Saúde , Saúde Pública , Previdência Social
12.
Health Econ ; 31(10): 2229-2243, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35851514

RESUMO

Governments are under pressure to raise the retirement age in response to an aging population and low fertility rates. However, the literature has not reached a consistent conclusion on the health effects of extending working lives. Furthermore, while most studies have concentrated on post-retirement health consequences, the health outcomes during the transition from work to retirement have been overlooked. Therefore, this article focuses on the transition period - the time between the early benefit age and full retirement age. Exploiting the increase in retirement age introduced by the U.S. Social Security Amendments of 1983, the difference-in-difference estimation finds that the reform successfully encouraged more people to work longer and claim benefits later, whilst having no adverse influence on health during the transition period. This paper infers that the desirable impacts of the 1983 amendments could be partly attributed to the adequate preparation time the reform left to the public.


Assuntos
Aposentadoria , Previdência Social , Idoso , Humanos , Renda , Estados Unidos
13.
BMC Health Serv Res ; 22(1): 909, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35831860

RESUMO

BACKGROUND: As a means of establishing a sustained and fair health care financing system, Ethiopia has planned and ratified a legal framework to introduce a social health insurance program for employees of the formal sector to protect them against financial and health burdens. However, the implementation has been delayed due to the resistance of public servants to pay the proposed premium. The aim of this study was to estimate the magnitude of willingness to pay the proposed amount of premium set by the government for the social health insurance program and the factors associated with it among public servants in Addis Ababa, Ethiopia. METHODS: An institution-based cross-sectional study design was used to conduct the study. Multistage sampling was employed to select a total of 503 from 12 randomly selected public sectors. Data were collected using pretested, interviewer-administered structured questionnaires. A contingent valuation method with an iterative bidding game was used to elicit willingness to pay. Finally, logistic regression analysis was used to identify independent predictors of willingness to pay. Statistical significance was considered at P < 0.05 with adjusted odds ratios calculated at 95% CIs. RESULTS: Only 35.4% were willing to pay the proposed premium (3% of their monthly salary). Those who had children from 6-18 years old (AOR = 3.252; 95% CI: 1.15, 9.22), had a history of unaffordable health service costs during the last 12 months (AOR = 9.631; 95% CI: 4.12, 22.52), and had prior information about the social health insurance program (AOR = 11.011, 95% CI. 3.735-32.462) were more likely to pay for the proposed social health insurance program compared to their counterparts. CONCLUSION: The willingness to pay the proposed amount premium for social health insurance among public servants in Addis Ababa was very low that implies the implementation will be challenging. Thus, the government of Ethiopia should consider reviewing the amount of premium contributions expected from employees before implementing the social health insurance scheme.


Assuntos
Seguro Saúde , Previdência Social , Adolescente , Criança , Estudos Transversais , Etiópia , Humanos , Inquéritos e Questionários
14.
Rev Gastroenterol Peru ; 42(1): 58-69, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35896076

RESUMO

INTRODUCTION: This article summarizes the clinical practice guide (CPG) for the diagnosis and management of cholelithiasis, acute cholecystitis and choledocholithiasis in the Peruvian Social Security (EsSalud). OBJECTIVE: To provide clinical recommendations based on evidence for the management of patients with cholelithiasis, acute cholecystitis and choledocholithiasis in EsSalud. METHODS: a guideline task force (GTF) was formed with internists, general surgeons, gastroenterologists, and methodologists. The group proposed 10 clinical questions to be answered in this Clinical practice guideline (CPG). Systematic searches of preview reviews were performed and when it was necessary, primary studies from PubMed and CENTRAL during 2017 were reviewed. The evidence was selected aiming to answer each proposed question. Certainty of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodical work sessions, the group used GRADE methodology for reviewing the evidence and formulating recommendations, good clinical practice items and three flowcharts for diagnosis and treatment. Finally, the CPG was approved by Resolution Nº 046-IETSI-ESSALUD-2017. RESULTS: This CPG approached 10 clinical questions divided into two topics: diagnosis and management. Based on these questions; one strong recommendation, five weak recommendations, and 17 good clinical practice items and three flowcharts were formulated. CONCLUSION: This paper abstracts the methodology and evidence-based conclusions of the CPG for diagnosis and management of cholelithiasis, acute cholecystitis and choledocholithiasis in EsSalud.


Assuntos
Colecistite Aguda , Colecistite , Coledocolitíase , Coledocolitíase/diagnóstico , Coledocolitíase/cirurgia , Humanos , Peru , Previdência Social
15.
Artigo em Inglês | MEDLINE | ID: mdl-35742744

RESUMO

(1) Background: To explore the relationship between health status, social security status, and the occurrence of depression in older adults and provide a basis for mental health care services for the elderly population; (2) Methods: This study used the 2018 China Health and Senior Care Tracking Survey (CHARLS) data to select 8383 older people aged over 60 years old as the research subjects. The two-category Logistic model was used to analyze the research problem; (3) Results: Older adults with depressive tendencies accounted for 34.1% of the total older adults. The incidence of depression among female older adults reached 41.51%. The risk of depression in the elderly population was 40.3% lower in males than in females (OR = 0.597, 95% CI: 0.539-0.662). Self-rated health status, physical disability, and receipt of pensions affected the incidence of depression in older adults (all p < 0.05); (4) Conclusions: Focus on and intervene in the mental status of elderly females and disabled elderly people. Provide mental and economic support and mental health care services to the elderly at the family and social levels. Promote the healthy development of the mental health of the elderly and promote active aging.


Assuntos
Depressão , Previdência Social , Idoso , China/epidemiologia , Depressão/epidemiologia , Feminino , Nível de Saúde , Humanos , Renda , Masculino , Pessoa de Meia-Idade
16.
Soc Sci Med ; 305: 115063, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35660694

RESUMO

In an era of considerable uncertainty about future prospects for development assistance to fund major health programmes in Sub-Saharan Africa, social health insurance is increasingly being considered as an alternative mechanism for increasing financing health. However, empirical support for social health insurance in sub-Saharan Africa remains sparse. The main aim of this study was to examine the viability of increasing health financing through social health insurance in Zambia. The paper uses a large nationally representative household survey to estimate the expected mean and total willingness to pay for social health insurance. The revenue potential of social health insurance for health sector funding is assessed. The results show that despite a high level of public support for social health insurance, with 80% willing to join a social insurance scheme, the estimated mean monthly willingness-to-pay is relatively low at Zambian Kwacha 55 (US$8.8 in 2014 dollars) per household. The evidence presented in this paper suggests that the revenue potential of social health insurance would not be sufficient to fund major improvements in quality of care for insured members, let alone cross-subsidize benefits to non-members.


Assuntos
Financiamento Pessoal , Previdência Social , Características da Família , Humanos , Seguro Saúde , Zâmbia
17.
Epidemiol Serv Saude ; 31(2): e2021777, 2022.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35730816

RESUMO

OBJECTIVE: To characterize the sociodemographic profile of beneficiaries of Brazilian social welfare affected by Chagas disease and identify factors associated with the granting of assistance benefits, 2004 to 2016. METHODS: Cross-sectional study based on secondary data from the Ministry of Labor and Social Security. Logistical regression was performed to estimate crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: 36,023 benefits were granted; 62.5% were to male; 67.0% to residents of urban areas; 46.7% to residents of Southeast region; 56.7% to people with chronic cardiac form; and 42.7% to the 50-59 age group. Residents of urban areas (OR = 134.9; 95%CI 78.0;233.2), Northeast macro-region (OR = 2.9; 95%CI 2.5;3.1), female (OR = 2.0; 95%CI 1.8;2.1) and age group 60 years or older (OR = 1.6; 95%CI 1,3;1,7) were factors associated with assistance benefits. CONCLUSION: Factors related to the area of residence, macro-region, sex and age group increased the chance of granting assistance benefits.


Assuntos
Doença de Chagas , Previdência Social , Brasil/epidemiologia , Doença de Chagas/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seguridade Social
18.
Rev Med Inst Mex Seguro Soc ; 60(3): 275-282, 2022 May 02.
Artigo em Espanhol | MEDLINE | ID: mdl-35759755

RESUMO

Background: Patient-centered care model improves quality of care, decreases unnecessary use of services, optimizes costs and quality of life and survival for cancer patients. Objective: To compare the patient-centered quality of care of prostate cancer patients with and without social security in two oncology hospitals in Mexico City. Material and methods: The information of the 2019 survey of prostate cancer patients in two oncology hospitals, one from the Mexican Institute of Social Security (IMSS) and the other from the Ministry of Health (SSA), was analyzed (n = 307). The survey included sociodemographic and patient-centered quality of care variables. A descriptive and bivariate analysis was performed to compare the quality of care between both hospitals using chi-square test, Fisher's exact test and Student's t test. Results: 234 patients treated at the IMSS and 73 at the SSA were included, with a mean age of 66.6 years. In both hospitals, more than 90% of the patients perceived respectful and coordinated care, as well as clear information. Only 58.9% of patients treated at SSA received information for decision-making, in contrast to 80.8% at IMSS (p = 0.001). Supportive care for biopsychosocial needs was low in both places (IMSS: 23.9%, SSA: 13.7%, p = 0.063). Conclusions: The quality of care focused on patients with prostate cancer was perceived as good, except in the care of biopsychosocial needs; given the importance of this last aspect, it is recommended a multidisciplinary approach in their care.


Introducción: la asistencia centrada en el paciente permite mejorar la calidad de atención, disminuye el uso innecesario de los servicios y optimiza costos y calidad de vida y sobrevida en pacientes con cáncer. Objetivo: : comparar la calidad de la atención en pacientes con cáncer de próstata con y sin seguridad social en dos hospitales de oncología de la Ciudad de México. Material y métodos: se usó información de una encuesta a pacientes con cáncer de próstata del 2019 de dos hospitales de oncología, uno del Instituto Mexicano del Seguro Social (IMSS) y otro de la Secretaría de Salud (SSA), n = 307. La encuesta incluyó variables sociodemográficas y de calidad de atención desde la perspectiva centrada en el paciente. Se hizo análisis descriptivo y bivariado para comparar la calidad de atención de ambos hospitales mediante chi cuadrada, prueba exacta de Fisher y t de Student. Resultados: se incluyeron 234 pacientes atendidos en el IMSS y 73 en la SSA; su edad promedio fue 66.6 años. Más del 90% percibieron una atención respetuosa y coordinada e información clara en ambos lugares. Solo 58.9% de pacientes atendidos en SSA recibieron información para la toma de decisiones en contraste con 80.8% de pacientes del IMSS (p = 0.001). Sin embargo, la atención de las necesidades biopsicosociales fue baja en ambos lugares (IMSS: 23.9%, SSA: 13.7%, p = 0.063). Conclusiones: la calidad de atención centrada en pacientes con cáncer de próstata fue percibida como buena, salvo la atención de necesidades biopsicosociales; dado esto último, se recomienda incorporar un abordaje multidisciplinario en su atención.


Assuntos
Neoplasias da Próstata , Qualidade de Vida , Idoso , Humanos , Masculino , México , Neoplasias da Próstata/terapia , Previdência Social , Inquéritos e Questionários
19.
Artigo em Inglês | MEDLINE | ID: mdl-35682450

RESUMO

Several studies have found that trust in government is associated with social fairness, citizens' satisfaction with public service, and life satisfaction. This study aimed to investigate the serial mediation effects of social security satisfaction and life satisfaction on the association between social security fairness and trust in government. We analyzed the data from the Chinese Social Survey in 2019 (n = 7403) to examine the serial mediation effects. The findings showed that the higher the level of government, the greater the trust it enjoyed from its citizens. The direct prediction of trust by social security fairness was stronger at the county and township levels than at the central government level. Both social security satisfaction and life satisfaction partially mediated the relationship between social security fairness and overall trust in government. Social security fairness indirectly positively predicted trust in local government at the county and township levels through social security satisfaction, life satisfaction, and their serial mediation. While social security fairness could only indirectly predict trust in central government through social security satisfaction, the prediction of trust in central government via life satisfaction (mediator) was not significant. We observed a serial mediation model in which social security fairness positively predicted trust in government directly and indirectly through social security satisfaction and life satisfaction. The finding that social security satisfaction partially mediates the relationship between perceptions of fairness in the social security system and trust in government has implications for improving policies and the functioning of the system at all levels of the government.


Assuntos
Previdência Social , Confiança , Governo , Renda , Satisfação Pessoal
20.
J Occup Environ Med ; 64(7): e409-e416, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35673247

RESUMO

PURPOSE: Increasing retirement-aged workers are encouraged to stay in the labor market, as delayed retirement initiative is proposed. This study investigates the interplay of late-life working participation and social security on the mental health risk of retirement-aged workers. METHOD: We applied data from the China Health and Retirement Longitudinal Study (CHARLS-2018), and the instrumental variables regression was conducted. RESULTS: Late-life working could alleviate depression, as did the beneficiary status of employment-based social health insurance and the pensionable phase of social pension participation. Besides, the role of late-life working in alleviating depression became more salient when late retirees were not insured by the employment-based social health insurance and still in the pension contribution phase. CONCLUSIONS: It is suggested that the current social security system in China has not been sufficiently well designed to protect the mental health of retirement-aged workers.


Assuntos
Aposentadoria , Previdência Social , Idoso , Humanos , Estudos Longitudinais , Saúde Mental , Pensões
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