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ObjectiveThe objective was to (i) assess the long-term cost-effectiveness of acceptance and commitment therapy (ACT), a workplace dialog intervention (WDI), and ACT+WDI compared to treatment as usual (TAU) for common mental disorders and (ii) investigate any differences in cost-effectiveness between diagnostic groups.MethodsAn economic evaluation from the healthcare and limited welfare perspectives was conducted alongside a randomized clinical trial with a two-year follow-up period. Persons with common mental disorders receiving sickness benefits were invited to the trial. We used registry data for cost analysis alongside participant data collected during the trial and the reduction in sickness absence days as treatment effect. A total of 264 participants with a diagnosis of depression, anxiety, or stress-induced exhaustion disorder participated in a two-year follow-up of a four-arm trial: ACT (N=74), WDI (N=60), ACT+WDI (N=70), and TAU (N=60).ResultsFor all patients in general, there were no statistically significant differences between interventions in terms of costs or effect. The subgroup analyses suggested that from a healthcare perspective, ACT was a cost-effective option for depression or anxiety disorders and ACT+WDI for stress-induced exhaustion disorder. With a two-year time horizon, the probability of WDI to be cost-saving in terms of sickness benefits costs was 80% compared with TAU.ConclusionsACT had a high probability of cost-effectiveness from a healthcare perspective for employees on sick leave due to depression or anxiety disorders. For participants with stress-induced exhaustion disorder, adding WDI to ACT seems to reduce healthcare costs, while WDI as a stand-alone intervention seems to reduce welfare costs.

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Background South Korea has the highest out-of-pocket burden for medical expenses among the Organisation for Economic Co- operation and Development (OECD) member countries and has no formal sickness benefit system, along with United States and Switzerland, greatly increasing the risk of poverty due to a sudden illness. Methods We identify the causal effect of health shocks on poverty status and explore the mechanisms of medical impoverishment by analyzing longitudinal data from 13 670 households that participated in the representative Korean Welfare Panel Study (KOWEPS) from 2007 to 2016. In this study, we define a health shock as a case in which no household members were hospitalized in the previous year, but together they had more than 30 days of hospitalization in this year. The propensity score matching method was combined with a mediation analysis in this work. Results The proportion of households in absolute poverty increased by 4.6–8.0 percentage points among households that experienced a health shock compared with matched controls. The selection effects due to health shock were estimated to be 5.6–8.2 percentage points. On average, a sudden hospitalization reduces annual non-medical expenditures and equivalized disposable income by just over 3.2 million KRW (2500 USD) and 1.2 million KRW (1000 USD), respectively. Health shock induces impoverishment after one year through both the medical expense and work capacity pathways, which explain 12.8% and 12.8% of the total effect, respectively. However, when we decompose the mediation effect of a health shock on poverty status after two years, we find that a health shock leads to poverty mainly through labor force nonparticipation (9.9%). Conclusion Income stabilizing scheme to protect households that experience a health shock should be introduced as a policy alternative to confront the issue of medical impoverishment.

The article is an attempt to draw attention to the intention of the Ministry of Family and Social Policy to shape its own legal policy with regard to the ability of the officials of the Social Insurance Institution (ZUS) to obtain information about individuals subject to official control. Within the proposed changes to Art. 61a of the Act of 25 June 1999 on cash benefits from social insurance in the event of sickness and maternity (Journal of Laws 1999, 60.636, as amended), the Ministry, not taking into account the requirement to ensure the existence of constitutionally guaranteed rights and freedoms, consciously shapes the law positive for full-range surveillance of every person covered by the interest of ZUS. In such circumstances, after adopting the amendments by the Polish Parliament (Sejm), ZUS will be included in the group of law enforcement authorities, as the scope of powers and possibilities its officials in the field have of obtaining information will be unlimited.

OBJECTIVE: The objective was to (i) assess the long-term cost-effectiveness of acceptance and commitment therapy (ACT), a workplace dialog intervention (WDI), and ACT+WDI compared to treatment as usual (TAU) for common mental disorders and (ii) investigate any differences in cost-effectiveness between diagnostic groups. METHODS: An economic evaluation from the healthcare and limited welfare perspectives was conducted alongside a randomized clinical trial with a two-year follow-up period. Persons with common mental disorders receiving sickness benefits were invited to the trial. We used registry data for cost analysis alongside participant data collected during the trial and the reduction in sickness absence days as treatment effect. A total of 264 participants with a diagnosis of depression, anxiety, or stress-induced exhaustion disorder participated in a two-year follow-up of a four-arm trial: ACT (N=74), WDI (N=60), ACT+WDI (N=70), and TAU (N=60). RESULTS: For all patients in general, there were no statistically significant differences between interventions in terms of costs or effect. The subgroup analyses suggested that from a healthcare perspective, ACT was a cost-effective option for depression or anxiety disorders and ACT+WDI for stress-induced exhaustion disorder. With a two-year time horizon, the probability of WDI to be cost-saving in terms of sickness benefits costs was 80% compared with TAU. CONCLUSIONS: ACT had a high probability of cost-effectiveness from a healthcare perspective for employees on sick leave due to depression or anxiety disorders. For participants with stress-induced exhaustion disorder, adding WDI to ACT seems to reduce healthcare costs, while WDI as a stand-alone intervention seems to reduce welfare costs.

OBJECTIVE: We aimed to investigate the influence of unobserved individual characteristics in explaining the effects of work-related factors on full (fSA) and part-time sickness absence (pSA). METHODS: We used register-based panel data for the period 2005–2016 on a 70% random sample of the Finnish working-age population. The relationships between employment sector and occupational exposures (% exposed to physically heavy work and job control score based on job exposure matrices) and the annual onset of fSA and pSA were investigated among men and women. First, random effects (RE) models were applied controlling for observed sociodemographic factors and then fixed effects (FE) models that examine within-individual changes over time and thereby further account for unobserved time-invariant individual characteristics. RESULTS: In the RE analyses, public employment sector, physically heavy work and lower job control each increased the use of fSA and pSA among both genders. When unobserved individual characteristics were controlled for with the FE models, the effects on fSA attenuated. For pSA, the effects of employment sector and physical heaviness of work among women even reversed. The effect of lower job control on pSA remained especially among women. CONCLUSIONS: The role of individuals’ unobserved characteristics in explaining the effects of work-related factors on SA should not be neglected. The effects of work-related factors are likely to be overestimated when using traditional approaches that do not account for unobserved confounding, ie, selection of individuals with a high likelihood of SA into particular work environments.

Objective We aimed to investigate the influence of unobserved individual characteristics in explaining the effects of work-related factors on full (fSA) and part-time sickness absence (pSA). Methods We used register-based panel data for the period 2005-2016 on a 70% random sample of the Finnish working-age population. The relationships between employment sector and occupational exposures (% exposed to physically heavy work and job control score based on job exposure matrices) and the annual onset of fSA and pSA were investigated among men and women. First, random effects (RE) models were applied controlling for observed sociodemographic factors and then fixed effects (FE) models that examine within-individual changes over time and thereby further account for unobserved time-invariant individual characteristics. Results In the RE analyses, public employment sector, physically heavy work and lower job control each increased the use of fSA and pSA among both genders. When unobserved individual characteristics were controlled for with the FE models, the effects on fSA attenuated. For pSA, the effects of employment sector and physical heaviness of work among women even reversed. The effect of lower job control on pSA remained especially among women. Conclusions The role of individuals' unobserved characteristics in explaining the effects of work-related factors on SA should not be neglected. The effects of work-related factors are likely to be overestimated when using traditional approaches that do not account for unobserved confounding, ie, selection of individuals with a high likelihood of SA into particular work environments. [ABSTRACT FROM AUTHOR]

The article is an attempt to draw attention to the intention of the Ministry of Family and Social Policy to shape its own legal policy with regard to the ability of the officials of the Social Insurance Institution (ZUS) to obtain information about individuals subject to official control. Within the proposed changes to Art. 61a of the Act of 25 June 1999 on cash benefits from social insurance in the event of sickness and maternity (Journal of Laws 1999, 60.636, as amended), the Ministry, not taking into account the requirement to ensure the existence of constitutionally guaranteed rights and freedoms, consciously shapes the law positive for full-range surveillance of every person covered by the interest of ZUS. In such circumstances, after adopting the amendments by the Polish Parliament (Sejm), ZUS will be included in the group of law enforcement authorities, as the scope of powers and possibilities its officials in the field have of obtaining information will be unlimited. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We analyzed social security costs based on an earlier quasi-experiment that compared work participation between partial sickness beneficiaries and a matched group of full sickness beneficiaries. METHODS: Utilizing a population-based 70% representative sample, 1878 persons with part-time sick leave (intervention group) due to musculoskeletal diseases or mental disorders at an early stage of work disability and their propensity-score-matched controls with full-time sick leave were followed for two years. The outcome was the difference (absolute and relative) in social security costs between the intervention and control groups during follow-up. Costs of sickness absence, vocational rehabilitation, unemployment, and retirement days were calculated from national administrative registers. RESULTS: A cost reduction of €2395 per person per year [95% confidence interval (CI) -2890– -1899) was observed in the intervention compared with the control group. The cost ratio was 0.512 (95% CI 0.511–0.513). The largest savings were attributable to differences in the costs of retirement and vocational rehabilitation. The savings were higher for the second compared with the first follow-up year. Costs were saved across both genders and diagnostic groups, however, savings for women with musculoskeletal diseases were lowest. CONCLUSIONS: Part-time instead of full-time sick leave, at the early stage of work disability due to musculoskeletal diseases or mental disorders, leads to considerable social security cost savings during two years, in correspondence with increased work participation and in addition to earlier reported health benefits. Part-time sick leave can be recommended from an economic perspective; however more consideration should be given to women with musculoskeletal diseases.

Copyright of Zeszyty Prawnicze Biuro Analiz Sejmowej is the property of Kancelaria Sejmu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

As Slovakia is one of the least affected countries in terms of the spread of the disease, except for doctors and employees in social services facilities, there was no serious threat to the health of employees. However, this is not due to the economic consequences of the pandemic, which threaten the competitiveness of employers. The new government tried to respond to the situation with legislative measures, which were adopted in quick succession, without discussion with the social partners and often in the form of indirect amendments, which in turn it makes it more difficult in orientation in the legislation. However, thanks to the intervention of the social partners, no measures have been taken that would worsen the position of employees in employment relations. The promised financial assistance for job retention is running very slowly.

In the case of Japan, a national-level “state of emergency declaration” has not yet been issued. If a worker is infected with Covid-19, the absence allowance will not be paid. Instead, the worker will receive an injury and sickness benefit. They are also eligible for workers' compensation insurance benefits. The government will subsidize the full amount of wages paid to companies that allow employees to take paid leave to care for children.

Mixed public/private governance regimes in social security are complex, legally intricate, and difficult to manage. This may operate as an obstacle for individual claimants when they want to protect themselves against decisions or actions of private actors or wish to enforce individual entitlements. Hence, individuals rely heavily on the corrective function exercised by the courts. Paradoxically, policies that create a public/private governance structure are not always geared towards strengthening access to justice for the individual. On the contrary, in the Netherlands, legislative changes and administrative practices purposefully raise the barriers to bringing cases to the independent judiciary. In this article, we analyse the relationship between the complex public/private governance regimes in social security and access to justice. It is argued that the policies should consider strengthening access to courts to counterbalance the weakened position of workers and vulnerable citizens. [ABSTRACT FROM AUTHOR]

Aims: To obtain more insight into differences in sick leave assessments of workers with subjective health complaints, we studied sick leave assessments among Dutch occupational and insurance physicians, and explored possible determinants for these differences. Methods: A cross-sectional study was conducted among 50 occupational and 43 insurance physicians in the Netherlands. They all assessed sick leave (complete, partial or no) of nine video case vignettes of workers with subjective health complaints and gave their opinion on the complaints, sick leave and health status. Data were analyzed via a multinomial regression approach, using generalized estimating equations in SPSS. Results: Compared to occupational physicians, complete sick leave was less likely to be assessed by insurance physicians (odds ratio 0.74, 95% confidence interval 0.56–0.97). For occupational physicians, psychological diagnoses, private issues and reduced work ability had more influence on the outcome of the sick leave assessment than for insurance physicians. Conclusion: There are differences in sick leave assessments for workers with subjective health complaints between physicians working in the same occupational health system; insurance physicians are stricter in assessing complete sick leave than occupational physicians. These differences may be explained by differences in roles, tasks and perspectives of the physician in occupational health care. Sick leave assessments of workers with subjective health complaints. • The current study showed that there are differences between occupational physicians and insurance physicians in sick leave assessments for workers with subjective health complaints. • These differences may be based on different perspectives, roles and tasks of physicians. • Physicians working in the rehabilitation and occupational health system should be more aware of the impact of these differences on their assessments and advices. • Better communication and collaboration between physicians, and more insight into and clarification of the perspectives may result in more agreement between physicians' sick leave assessment and advice towards workers. [ABSTRACT FROM AUTHOR]

Objectives We analyzed social security costs based on an earlier quasi-experiment that compared work participation between partial sickness beneficiaries and a matched group of full sickness beneficiaries. Methods Utilizing a population-based 70% representative sample, 1878 persons with part-time sick leave (intervention group) due to musculoskeletal diseases or mental disorders at an early stage of work disability and their propensity-score-matched controls with full-time sick leave were followed for two years. The outcome was the difference (absolute and relative) in social security costs between the intervention and control groups during follow-up. Costs of sickness absence, vocational rehabilitation, unemployment, and retirement days were calculated from national administrative registers. Results A cost reduction of €2395 per person per year [95% confidence interval (CI) -2890- -1899) was observed in the intervention compared with the control group. The cost ratio was 0.512 (95% CI 0.511-0.513). The largest savings were attributable to differences in the costs of retirement and vocational rehabilitation. The savings were higher for the second compared with the first follow-up year. Costs were saved across both genders and diagnostic groups, however, savings for women with musculoskeletal diseases were lowest. Conclusions Part-time instead of full-time sick leave, at the early stage of work disability due to musculoskeletal diseases or mental disorders, leads to considerable social security cost savings during two years, in correspondence with increased work participation and in addition to earlier reported health benefits. Part-time sick leave can be recommended from an economic perspective; however more consideration should be given to women with musculoskeletal diseases. [ABSTRACT FROM AUTHOR]

Background: Social insurance offices (SIOs) handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably.Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits.Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group.Results: The participants discussed different dilemmas in regard to; physicians’ responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits.Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members.

Aims: This study investigated: (i) the workforce participation in Sweden among older employees before and after changes in eligibility for sickness absence and unemployment compensation by a social insurance reform; and (ii) absence and early exit mechanisms from the workforce for different professions by looking at sickness benefits, disability pension and unemployment, early statutory pension, employment pension and unregistered economic supply. Methods: A register-based follow-up study of the total Swedish workforce population of 55–64-year-olds, measured in 2004 and 2011. Results: The total proportion of individuals aged 55–64 in the workforce increased between 2004 and 2011, but the increase was mostly in professions with lower educational requirements, a lower salary and dominated by women. Both in 2004 and in 2011, men in professions with higher educational requirements more often exit working life with an early statutory pension and employment pension. In contrast, professions with lower educational requirements more often absence working life with sickness benefits, disability pension and unemployment compensation than other professions in both 2004 and 2011. Conclusions: The change in regulations seems to have contributed to an overall shrinking proportion of individuals within the sickness benefit and disability pension schemes. At the same time the proportion of individuals taking an early pension has increased. The results indicated a tendency of passing on the costs of labour-market exit within different economic compensation arrangements, as well as to the individuals themselves; for example, less sickness benefit, disability pension, but more statutory pension and employment pension earlier. [ABSTRACT FROM AUTHOR]

Sickness insurance is a part of social security and its task is to insure people participating in this system by the insurance benefits at law intended social events in order to reduce or completely eliminate the effects of these events. Reform steps in the sphere of sickness insurance and sickness benefits, especially the fact that during the temporary incapacity for work the benefits were provided only from the 22nd day, influenced the decisions of employees about their incapacity for work significantly. The aim of this paper is to give an idea of sickness insurance, especially the impact of legal regulation changes in the system of this insurance on employees, who represent the largest share of social insured persons focusing on the Moravian-Silesian Region. The impact of changes in sickness insurance will be presented by selected indicators of temporary incapacity for work using regression analysis to estimate the development of individual indicators in the following years based on knowledge of the development of indicators in the years 2000-2013. [ABSTRACT FROM AUTHOR]

Background: This register study aims to increase the knowledge on how common it is that sickness benefit recipients are sick-listed for as long as their physician prescribes in their medical sickness certificate, i.e. sick-listing adherence, or wholly/partly bring return-to-work (RTW) forward, i.e. early RTW. Methods: The unit for analysis was an episode of 100% sickness benefit, commenced between 1 January 2010 and 31 December 2013. Completed episodes of sickness benefit and full or partial early RTW was analysed by comparing the prescribed length of sick leave in medical sickness certificates and benefit days disbursed by the sickness insurance system. Probability for a full and partial early RTW was estimated with hazard ratio (HR) using the Cox proportional hazard model. Results: In total, about 1.4 million episodes of sickness benefit (60% women) were included in the study. The overall sick-listing adherence was 84% for women and 82% for men during the first year of sick leave. Adherence varied between 82 and 87% among women and between 79 and 86% among men with regard to ICD-10 diagnosis chapter. The probability of an early RTW varied between diagnosis chapters, where mental disorders was associated with a lower probability of a full early RTW among women and men (HR 0.52 and HR 0.47) as well as a partial early RTW (HR 0.51 and HR 0.46). Younger age (16-29 years), high educational level and high income was associated with a higher probability of an early RTW, while older age (⩾50 years), not native-born, low educational level, unemployment and parental leave were associated with a lower probability. Conclusion: The study demonstrates that sick-listing adherence is relatively high. Probability of an early RTW differs with regard to diagnosis chapter, demographic, socioeconomic and labour market characteristics of the sickness benefit recipients. Interventions intended to improve the sick-listing process, and to affect the length and degree of sick leave in certain target groups, should include measures targeted at physicians' sick-listing practices. Policies and economic incentives aimed at promoting RTW need to focus on individuals' residual capacity for work. [ABSTRACT FROM AUTHOR]

This article examines the co-production of narratives based on an analysis of audio recordings from 12 statutory lay-interprofessional meetings involving clients and concerning rehabilitation for return-to-work. Using Bakhtin's (1981) notion of voice in a similar vein to Mishler (1984), it is argued that a voice represents a specific normative order, displayed in the way of speaking. The premises of the approach taken is that citizens' problems and needs are often presented as stories and that this particular type of meeting opens up the possibility for what Wertsch (1991) calls multi-voicedness. Three patterns of co-narrating the client's story of illness and the process of rehabilitation were found. In the most frequently recurring form, there was one primary storyteller and another participant who joined in as a co-teller. Another pattern was that dyadic co-narrated episodes commonly drew on prior contacts between the two storytellers. A third salient feature was how storytelling episodes involved revoicing an absent expert - that is, the interactional move when a speaker makes use of someone else's words, and what Bakhtin (1981) calls rhetorical double-voicedness. Due to the multi-voicedness character, co-narrated stories in lay-interprofessional meetings often represent two or more perspectives and are founded on the blending of voices. [ABSTRACT FROM AUTHOR]

The author of the draft claims that the challenged Article 80 paragraph 1 of the Act is in compliance with Article 31, in conjunction with Article 18, of the Constitution. Furthermore, the author requests that the case be discontinued pursuant to Article 39 paragraph 1(3) of the Constitutional Tribunal Act owing to the fact that the challenged provisions had ceased to have effect (Article 244 paragraph 1 and Article 245 paragraph 1 of the above mentioned Act) before the Constitutional Tribunal passed its judgment. [ABSTRACT FROM AUTHOR]

The article provides information on the use, effects, and feasibility of partial sick leave in the Nordic countries. It is stated that of the sickness benefits, partial benefits accounted for one-fifth in the region, indicating that partial leave's acceptance was good in Nordic. Sickness absenteeism, sickness benefit, and work disability are discussed thoroughly.

The development of health and sickness insurance plans displays some specific features in each country. Consequently, national plans of health and sickness vary across countries. The authors pay a special attention to contemporary conditions in this area in Great Britain, Slovakia and United States. The process of approximation, as described in the introductory part of the paper, has been started as a result of harmonization in Europe, as well as of the increase in an overall movement of persons on international level. One of the means of approximation is actuarial mathematics, which is dealt with in the final part of this paper. This mathematical instrument is currently applied in all the countries mentioned. More and more often in actuarial calculations in life insurance use is made of new modern methods. The old deterministic approach is giving way to new stochastic methods. One example of a deterministic method is dealt with in this article. The authors go on to show how the models described can be used to carry out actuarial calculations for a model sickness insurance contract and a model health contract. Calculation of the premium for each model contract is carried out by following the transitions between the various states. The authors believe that the unifying approach provided by deterministic models is very important also for a Slovak insurance companies, it allows a well organized presentation of the statistics of the sickness insurance of the person and, in particular, of health care. [ABSTRACT FROM AUTHOR]

Background: The sickness certificate is a major instrument for establishing contact and conveying information between two authorities that have a substantial impact on the life situation and work situation of the patients, as well as on the economic costs of the society. Aim: A study was undertaken to assess the quality of physicians' sickness certificates as a basis for social insurance officers' decisions regarding entitlement to sickness benefits. Method: Information on all 2,449 sickness certificates for sick‐leave periods exceeding 28 days' sick leave period received at the social insurance offices in one Swedish county during one week in 2002 was coded and analysed. Results: Information provided in the certificates was often not sufficient to allow social insurance officers to determine eligibility for sickness benefits. Qualitative analyses of certificates from general practitioners (GPs) revealed that 21% contained ambiguous statements about the medical disorder, 30% were unclear regarding the assessment of functional capacity, and 22% required additional information on both those aspects. Sickness certificates issued by GPs and physicians under specialist training, as compared with other categories of physicians, more often provided essential data, for example concerning the patient's occupational tasks and type of employment. Conclusions: Physicians often fail to contribute required information concerning functional capacity and other important aspects when issuing sickness certificates. This limits the use of these documents as a basis for decisions regarding sickness insurance benefits. The practical consequences of incomplete certificates might be delayed payment of benefits and delayed initiation of return to work measures. [ABSTRACT FROM AUTHOR]

Decisions concerning entitlement to sickness benefits have a substantial impact on the lives of individuals and on society. In most countries, such decisions are made by staff of private or public insurance organisations. The work performed by these professionals is debated, hence more knowledge is needed on this subject. The aim of the present study was to review scientific studies of the practices of social insurance officers (SIOs) published in English, Danish, Norwegian and Swedish. Studies were searched for in literature databases, in reference lists, and through personal contacts. Analyses were made of type of study, areas investigated, research questions, theories used, and the results. Sixteen studies were included. SIOs and several other actors are responsible for applying measures to minimise sick-leave and promote return to work (RTW). The studies focusing on coordination of such measures revealed that SIOs felt unsure about how to handle their contacts with clients and other actors. One study indicated that the SIOs, partly due to lack of time, accepted the recommendations of physicians instead of making their own judgments about granting sickness benefits. While all SIOs must make decisions concerning entitlement to sickness benefits on a daily basis, few of the reviewed studies scrutinised the actual granting of sickness compensation. The studies were also deficient in that they investigated the decision latitude of the SIOs from a very limited perspective, mainly on an individual level and often primarily in relation to colleagues and/or clients rather than to the laws and regulations of the sickness insurance. The concepts and framework in this area of research need to be developed to facilitate elucidation of the interaction between different actors in local spheres, professionals in different disciplines, and between welfare staff and individual citizens. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has revealed the importance of social protection systems, including income security, when health problems arise. The aims of this study are to compare the follow-up regimes for sick-listed employees across nine European countries, and to conduct a qualitative assessment of the differences with respect to burden and responsibility sharing between the social protection system, employers and employees. The tendency highlighted is that countries with shorter employer periods of sick-pay typically have stricter follow-up responsibility for employers because, in practice, they become gatekeepers of the public sickness benefit scheme. In Germany and the UK, employers have few requirements for follow-up compared with the Nordic countries because they bear most of the costs of sickness absence themselves. The same applies in Iceland, where employers carry most of the costs and have no obligation to follow up sick-listed employees. The situation in the Netherlands is paradoxical: employers have strict obligations in the follow-up regime even though they cover all the costs of the sick-leave themselves. During the pandemic, the majority of countries have adjusted their sick-pay system and increased coverage to reduce the risk of spreading Covid-19 because employees are going to work sick or when they should self-quarantine, except for the Netherlands and Belgium, which considered that the current schemes were already sufficient to reduce that risk., (Copyright © 2022. Published by Elsevier B.V.)

This article investigates the extent to which the entry of female workers into long-term receipt sickness benefit is related not of to their health status but also to the experience of women in the labour market. It is argued that specific categories female workers women with children, women who enter sickness benefit from maternity or unemployment benefit or who live in areas of high female unemployment--have an incentive to remain on sickness benefit long-term. This is supported by a logistic regression analysis on a random sample (n = 1142) of individual social security sickness benefit claimants in the Republic Ireland. The results can be used to understand how married, compared to single, women can come to be overrepresented among those on long-term sickness benefit. [ABSTRACT FROM AUTHOR]

Objetivo estimar a prevalência de Benefícios Auxílio-Doença (BAD) entre trabalhadores do ramo da Construção e a potencial influência do sexo, idade e ramo de atividade no quadro de incapacidade para o trabalho, no Brasil, em 2009. Método estudo transversal de base populacional baseado nos BAD concedidos pela Previdência Social. Do Sistema Único de Benefícios e do Cadastro Nacional de Informações Sociais extraíram-se informações sobre ramo de atividade, sexo, idade, causa clínica e espécie de benefício. A população de estudo correspondeu à média mensal dos vínculos empregatícios declarados em 2009 (1.784.772). Resultados foram concedidos 81.235 BAD, resultando em prevalência de 455,2/10.000 vínculos, com predomínio da espécie BAD previdenciária (Razão de Prevalência [RP] 3,1), do sexo masculino (RP 1,3) e dos ramos de atividade Obras de acabamento, Construção de obras de arte e Obras de terraplenagem. Homens caracterizaram 76,7% mais BAD acidentários que mulheres. As principais causas diagnósticas foram Lesões, Doenças osteomusculares e Doenças digestivas. As categorias clínicas mais prevalentes foram Dorsalgia, Fratura ao nível do punho e da mão, Fratura da perna e Hérnia inguinal. A prevalência aumentou com a idade. Conclusão a prevalência mostrou-se influenciada pela espécie de benefício, ramo de atividade, sexo e idade. Os resultados sugerem potenciais mecanismos de subnotificação/demanda previdenciária.

Background: Various data sources on sick pay exist in the German health care system. For future analyses, it is relevant to know which data sources are suitable for which research questions, which variables they include, how they can be accessed and which limitations are to be considered. This article offers a comprehensive overview., Methods: The German Advisory Council on the Assessment of Developments in the Health Care System used various data sources for its special report on sick pay. For this purpose, several individual agreements with institutions have been made. Insights from these analyses have been systematically analysed and described., Results: Important data sources on sick pay and sick pay recipients include the official statistics hosted by the Federal Ministry of Health and the data of single sickness funds. Moreover, the dataset of the morbidity-oriented risk structure compensation scheme includes some information on sick pay - partly on a regional level. Furthermore, data on cases of long-term incapacity to work, e. g. from the AOK sickness funds, can be used as an approximation for sick pay cases. The available data sources differ regarding available variables, data format, available time course and representativeness., Discussion and Conclusion: Which data source is most suitable for analyses of sick pay and sick pay recipients, strongly depends on the research question. There may be a trade-off between depth and applicable analytical methods on the one hand (e. g. with data of single sickness funds) versus representativeness and a long-term course on the other hand (e. g. with official statistics). Finally, several recommendations are made on how to further improve the informative value and comparability of data, especially among sickness funds., (Copyright © 2018. Published by Elsevier GmbH.)

Background: Disability either due to illness, aging, or both causes remains an essential contributor shaping European labor markets. Ability of modern day welfare states to compensate an impaired work ability and absenteeism arising from incapacity is very diverse. The aims of this study were to establish and explain intercountry differences among selected European OECD countries and to provide forecasts of future work absenteeism and expenditures on wage replacement benefits., Methods: Two major public registries, European health for all database and Organization for Economic Co-operation and Development database (OECD Health Data), were coupled to form a joint database on 12 core indicators. These were related to disability, work absenteeism, and sickness benefits in European OECD countries. Time horizon 1989-2013 was observed. Forecasting analysis was done on mean values of all data for each single variable for all observed countries in a single year. Trends were predicted on a selected time horizon based on the mean value, in our case, 7 years up to 2020. For this purpose, ARIMA prediction model was applied, and its significance was assessed using Ljung-Box Q test., Results: Our forecasts based on ARIMA modeling of available data indicate that up to 2020, most European countries will experience downfall of absenteeism from work due to illness. The number of citizens receiving social/disability benefits and the number being compensated due to health-related absence from work will decline. As opposed to these trends, cancer morbidity may become the top ranked disability driver as hospital discharge diagnoses. Concerning development is the anticipated bold growth of hospital discharge frequencies due to cancer across the region. This effectively means that part of these savings on social support expenditure shall effectively be spent to combat strong cancer morbidity as the major driver of disability., Conclusion: We have clearly growing work load for the national health systems attributable to the clinical oncology acting as the major disability contributor. This effectively means that large share of these savings on public expenditure shall effectively be spent to combat strong cancer morbidity. On another side, we have all signs of falling societal responsibility toward the citizens suffering from diverse kinds of incapacity or impaired working ability and independence. Citizens suffering from any of these causes are likely to experience progressively less social support and publicly funded care and work support compared to the golden welfare era of previous decades.

Background: Social insurance offices (SIOs) handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably., Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits., Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group., Results: The participants discussed different dilemmas in regard to; physicians' responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits., Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members.