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How to select appropriate cases for rehabilitation management - approach of the German Social Accident Insurance 如何选择合适的个案进行康复管理——德国社会意外保险的做法
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/idm.2014.43
T. Köhler
In Germany, people injured in occupational-related accidents are offered comprehensive benefits ranging from medical care to occupational and social reintegration. Statutory accident insurance, funded solely by employers’ contributions, has developed specific structures and practical guidelines for rehabilitation management. This management process involves comprehensive planning, coordination and targeted encouragement and support for those needing rehabilitation. Rehabilitation management must commence promptly, be properly coordinated and achieve long-term effects. The measures deployed aim at restoring health and fitness to work as quickly and comprehensively as possible. In cases involving serious injury, rehabilitation management includes individual counselling and support as a follow-up to the primary medical care and extends beyond medical rehabilitation to include measures that assist occupational and social inclusion. Rehabilitation management demands considerable financial and human resources. To justify this relatively high expenditure, the cases involved need to be identified carefully based on relevant criteria. The accident insurance institutions have investigated how well this works in practice on the basis of their own experience and a wide range of case studies. An extremely important factor is the severity and complexity of the injury. A prognosis of inability to work for more than 112 days determines eligibility as a case needing rehabilitation management because occupational or social integration is at risk. Medical, psychological and social risk factors also need considering, as do the specific occupational requirements. A person's social and professional environment has to be taken into account from the very start. These variables must be examined and analysed as methodically as possible to establish the appropriate course of action.
在德国,工伤伤者可获得从医疗到重新融入职业和社会的全面福利。法定意外保险完全由雇主供款,为康复管理制定了具体的结构和实用准则。这一管理过程包括全面规划、协调和有针对性地鼓励和支持需要康复的人。康复管理必须及时开展,协调到位,实现长效。所采取的措施旨在尽快和全面地恢复健康和工作能力。在涉及严重伤害的情况下,康复管理包括个人咨询和支助,作为初级医疗保健的后续工作,并延伸到医疗康复之外,包括协助职业和社会融入的措施。康复管理需要大量的财政和人力资源。为了证明这笔相对较高的开支是合理的,需要根据有关标准仔细查明所涉及的案件。意外保险机构根据自己的经验和广泛的案例研究,调查了这种做法在实践中的效果。一个极其重要的因素是损伤的严重性和复杂性。无法工作超过112天的预后决定了需要康复管理的资格,因为职业或社会融合存在风险。医疗、心理和社会风险因素以及具体的职业要求也需要考虑。一个人的社会和职业环境必须从一开始就考虑进去。必须尽可能有条不紊地审查和分析这些变数,以确定适当的行动方针。
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引用次数: 0
Realising the health benefits of safe work - a continuing professional education for primary care practitioners 实现安全工作对健康的好处——初级保健从业人员的持续专业教育
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/IDM.2014.34
Kevin Sleigh
Background: General Practitioners complete around 91% of compensable certificates, and play a significant role in promoting the awareness of the health benefits of work. The Australasian Consensus Statement on the Health Benefits of Work developed by the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) has been endorsed by 100 organisations including the Royal Australian College of General Practitioners (RACGP). The Victorian WorkCover Authority and TAC has undertaken a program of work focussing on the delivery of a general practice education and awareness raising program. Objectives: The objectives of the program were to; engage Medicare Locals to undertake a general practice education and awareness raising program, develop training materials for Medicare Local staff to undertake practice liaison visits, recruit and train General Practice peer educators to deliver in-practice education and develop and deliver content for continuing professional development events in selected Medicare Locals. Methods: A suite of educational resources were developed and tailored to suit delivery in a General Practice setting. The Medicare Locals were targeted if they had high certification rates, the educational events were delivered in-practice settings and Principal findings The practice target was reached in all Medicare Locals, a total of 457 general practices across the five Medicare Locals were visited. The program was successful in raising awareness of the health benefits of work amongst GPs and practice staff. Discussion: The education has given general practitioners the impetus to talk to patients early about the health benefits of work and has the potential for GPs to be more confident in their clinical management of compensable patients. Conclusion: That the educational program continue with the Victorian WorkCover Authority and TAC working with key peak bodies and medical colleges to ensure education about the Health Benefits of Safe Work become a mandatory component of all GP postgraduate training.
背景:全科医生完成了约91%的可补偿证书,并在促进对工作健康益处的认识方面发挥了重要作用。由澳大利亚职业和环境医学学院(AFOEM)制定的《关于工作对健康有益的澳大利亚共识声明》已得到包括澳大利亚皇家全科医生学院(RACGP)在内的100个组织的认可。维多利亚州工作保险管理局和TAC开展了一项工作方案,重点是提供一般实践教育和提高认识方案。目标:该计划的目标是;与当地医疗保险公司合作开展全科医疗教育和提高认识项目,为当地医疗保险公司员工开发培训材料,进行实习联络访问,招募和培训全科医疗同行教育者,提供实践教育,并为选定的当地医疗保险公司的持续专业发展活动开发和提供内容。方法:一套教育资源的开发和定制,以适应在全科实践设置交付。如果当地医疗保险的认证率高,教育活动在实践环境中进行,主要调查结果是,所有当地医疗保险都达到了实践目标,总共访问了5个当地医疗保险的457个全科诊所。该方案成功地提高了全科医生和执业人员对工作对健康的好处的认识。讨论:这种教育使全科医生有动力尽早与病人讨论工作对健康的好处,并有可能使全科医生在临床管理可补偿病人时更有信心。结论:教育方案应由维多利亚州工作保险管理局和TAC与主要高峰机构和医学院合作继续进行,以确保有关安全工作的健康益处的教育成为所有全科医生研究生培训的强制性组成部分。
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引用次数: 0
The impact of work injury and permanent impairment on the probability of poverty 工伤和永久性伤残对贫困概率的影响
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/idm.2014.22
E. Tompa
Objectives: We investigate the prevalence of poverty across different workers compensation programs using large representative samples of workers’ compensation claimants who have sustained a permanent impairment from a work injury. The programs, which have existed in the provinces of Ontario and British Columbia, Canada over the last 25 years, are the Permanent Disability (PD) program, the Future Economic Loss (FEL) program, the Loss of Earnings (LOE) program, and the Bifurcated Benefits (BB) program. The nature of benefit determination and the return to work supports provided by the four programs are very different. The focus of the study is on evidence of programmatic impact on the probability of poverty in the nine years post injury. Methods: The study included claimants sampled from each of the four programs who sustained a permanent impairment from a work injury. Claimants were identified in a Revenue Canada tax database know as the Longitudinal Administrative Databank (LAD), which is a longitudinal 20% simple random sample of all Canadian tax filers. Each claimant was matched with similar uninjured controls that were also in the LAD, based on sex, age, labour-market earnings amounts and trajectories in the four years prior to injury, family income, marital status, number of children, and a propensity score. Descriptive analysis was undertaken to compare near poverty, poverty and deep poverty levels of claimants relative to their match controls using data on family and individual earnings over a ten-year period post injury. Statistical modeling was used to determine the probability of poverty and near poverty for claimants versus controls. A key issue of interest was to determine was whether the probability of poverty differed between programs. Results: Based on after-tax adjusted family income, the level of poverty was quite low, less than 2% in every program over a ten-year period. The level of poverty was also lower for claimants than their matched controls, but only nominally so. The BB program had the lowest proportion of poverty followed by the PD program, the FEL program and then the LOE program. In the statistical modelling analysis male claimants did not have a higher probability of poverty compared to controls, though female claimants did. Both male and female claimants had a higher probability of near poverty. Conclusions: Poverty levels are very low for workers’ compensation claimants who sustain permanent impairments from a work injury across different programs and time periods in Ontario and British Columbia. Overall the Bifurcated Benefits program from British Columbia had the lowest proportion of claimants in poverty in absolute terms and relative to non-injured workers. Increased levels of poverty due to work injury and permanent impairment are particularly a concern for female claimants, though both female and male claimants have a higher chance of near poverty compared to non-injured workers.
目的:我们使用大量具有代表性的工伤索赔索赔人样本,调查了不同工伤赔偿计划中贫困的普遍程度。在过去的25年里,加拿大安大略省和不列颠哥伦比亚省的这些计划分别是永久性残疾(PD)计划、未来经济损失(FEL)计划、收入损失(LOE)计划和双重福利(BB)计划。这四种方案所提供的福利确定和重返工作支持的性质非常不同。这项研究的重点是研究项目对受伤后九年内贫困概率的影响。方法:该研究包括从四个项目中抽取的索赔人,他们因工伤而遭受永久性损害。申请人是在加拿大税务局的纵向管理数据库(LAD)中确定的,该数据库是所有加拿大税务申报人的纵向20%简单随机样本。根据性别、年龄、劳动力市场收入和受伤前四年的发展轨迹、家庭收入、婚姻状况、子女数量和倾向评分,将每个索赔人与LAD中类似的未受伤对照进行匹配。使用受伤后十年期间的家庭和个人收入数据,进行描述性分析,比较索赔人相对于其匹配控制的接近贫困、贫困和深度贫困水平。统计模型被用来确定贫困和接近贫困的概率为索赔人与对照组。我们感兴趣的一个关键问题是确定不同项目之间的贫困概率是否不同。结果:根据税后调整的家庭收入,贫困水平相当低,十年来每个项目的贫困水平不到2%。这些人的贫困水平也比他们的对照组低,但只是名义上的。BB计划的贫困比例最低,其次是PD计划、FEL计划和LOE计划。在统计模型分析中,与对照组相比,男性索赔人没有更高的贫困可能性,但女性索赔人却有更高的可能性。男性和女性申请者都有更高的接近贫困的可能性。结论:在安大略省和不列颠哥伦比亚省的不同项目和时期,因工伤而遭受永久性损害的工人赔偿索赔人的贫困水平非常低。总体而言,不列颠哥伦比亚省的分岔福利计划在绝对数量和相对于未受伤工人的贫困索赔人中所占比例最低。由于工伤和永久性损伤而增加的贫困水平是女性索赔人特别关注的问题,尽管与未受伤的工人相比,女性和男性索赔人都有更高的接近贫困的机会。
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引用次数: 0
Patterns of healthcare service utilisation by injured workers following medical certification 医疗证明后受伤工人利用保健服务的模式
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/idm.2014.58
R. Ruseckaite
Background: Medical certification of injured workers is a routine occurrence in most General Practitioners (GPs) offices. GPs play an important role in return-to-employment after a work-related injury. Objectives: To examine patterns of healthcare service utilisation (HSU) in injured workers by condition and type of medical certificate issued by the GP at the initial consultation. Methods: Zero-inflated negative binomial regression (ZINB) was conducted for major healthcare services accessed by injured workers over the 12-month period post-initial medical examination. Services included GP consultations, pharmacy, physiotherapy, occupational rehabilitation, psychology and others. Logistic regression was conducted for hospital and occupational therapy services. All models were adjusted for the injured worker's gender, age, injury type, certification type, occupation and residential location. Findings: HSU differed according to the type of initial medical certificate and worker condition. Compared to other conditions, for unfit for work (UFW) and alternate duties (ALT) certificates, the average number of physiotherapy services was greater in workers with musculoskeletal disorders (MSD), back pains and strains and fractures. In contrast, for both UFW and ALT certificates, the mean number of psychological services was greater in mental health conditions (MHC). Workers suffering from MHCs were more likely to access pharmacy and psychological services. Workers with ALT certificates were more likely to use GPs, pharmacy and physiotherapy services. They were less likely to access occupational rehabilitation, psychology or other services. Discussion: HSU in the 12 months post-initial medical certification varied substantially according to the worker's medical condition, certificate type, occupation, age, gender and residential location. Conclusion: Understanding these socio-demographic characteristics that influence HSU can facilitate more appropriate resource allocation, strategic thinking on optimal use of particular health services and enable better targeting of particular provider groups for more education on the health benefits of RTW and safe work.
背景:受伤工人的医疗证明是大多数全科医生(gp)办公室的常规事件。全科医生在工伤后重返就业方面发挥着重要作用。目的:检查医疗保健服务利用模式(HSU)在受伤工人的条件和类型的医疗证明,由全科医生在初步咨询。方法:采用零膨胀负二项回归(ZINB)对工伤职工初次体检后12个月内就诊的主要医疗服务进行统计分析。服务包括全科医生咨询、药房、物理治疗、职业康复、心理学等。对医院和职业治疗服务进行Logistic回归。所有模型均根据工伤工人的性别、年龄、工伤类型、证件类型、职业和居住地点进行调整。结果:HSU根据初始医疗证明的类型和工人状况不同而不同。与其他条件相比,对于不适合工作(UFW)和替代职责(ALT)证书,患有肌肉骨骼疾病(MSD),背部疼痛,拉伤和骨折的工人的平均物理治疗服务次数更多。相比之下,对于UFW和ALT证书,心理健康状况(MHC)的平均心理服务次数更多。患有mhc的员工更有可能获得药房和心理服务。拥有ALT证书的员工更有可能使用全科医生、药房和物理治疗服务。他们不太可能获得职业康复、心理或其他服务。讨论:首次医疗证明后12个月内的HSU根据工人的医疗状况、证明类型、职业、年龄、性别和居住地点而有很大差异。结论:了解影响HSU的这些社会人口特征可以促进更适当的资源分配,对最佳利用特定卫生服务进行战略思考,并能够更好地针对特定提供者群体,对RTW的健康益处和安全工作进行更多教育。
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引用次数: 0
Taking a practical look at the Americans with Disabilities Act (ADA) in the United States 以美国《美国残疾人法案》为例
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/IDM.2014.48
Carrie Bibens
This presentation will provide a practical look at the Americans with Disabilities Act (ADA) in the United States. This disability non-discrimination act has undergone recent amendments changing the landscape for employers and changing their responsibilities to stay compliant. We will review how the changes in the ADA differ today for employers in the United States and we will also provide a comparison with other discriminatory acts in the world. The changes to be discussed include issues of “qualification” and “reasonableness” of accommodation and what these changes mean to real employer examples. The example will demonstrate one disability insurance carrier's approach to addressing this change by providing in support of their policyholders’ responsibilities to stay compliant.
本演讲将从实际角度介绍美国残疾人法案(ADA)。这项不歧视残疾人的法案最近进行了修订,改变了雇主的处境,也改变了他们遵守法律的责任。我们将回顾今天《美国残疾人法》的变化对美国雇主有何不同,我们还将与世界上其他歧视行为进行比较。要讨论的变化包括住宿的“资格”和“合理性”问题,以及这些变化对真实雇主的影响。该示例将演示一家残疾保险公司通过支持其保单持有人保持合规的责任来解决这一变化的方法。
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引用次数: 0
Developing the Social Security Organisation (SOCSO) of Malaysia's RTW case management system 发展马来西亚RTW案件管理系统的社会保障组织(SOCSO)
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/IDM.2014.45
E. Cheong
The Social Security Organisation (SOCSO) of Malaysia introduced the Return to Work (RTW) Program in 2007 which is a comprehensive multidisciplinary biopsychosocial rehabilitation program for its Insured Persons who are experiencing disability due to accidents in the workplace or those claiming for invalidity. This rehabilitation program is unique as it involves the concept of “disability management” in which each Insured Person who is referred to the program, is assigned to a Disability Case Manager who is actively involved throughout the return to work process. Up to date (December 2013), 11,090 workers were motivated to participate in the SOCSO RTW Programme, and this requires many work processes, countless paper-work and massive physical files and document management. Due to this massive information flow, the demand for a more efficient information system is needed. From the beginning, the whole idea was to create an accessible, quick and user-friendly application. The application is now used by the SOCSO RTW Department in managing their information. This application was built on an open source platform which can be access through the internet. It is also a “learning application” where it uses its historical data to assist the case managers to generate standard rehabilitation plans and forecast possible return to work outcomes. The beauty of such application is that it is easily replicated, configurable (email notifications, reminders, etc) to meet the needs of the case managers in various jurisdiction. The scope of the application can also be easily defined to meet the size of an enterprise using the application. With better management of information, this application has contributed in reducing processing time, repetitive paperwork, minimal storage areas and almost real-time flow of information in the SOCSO's RTW Case Management system. Apart from that, the application now stores a wealth of information such as rehabilitation strategies for various disability or illnesses or demographic backgrounds.
马来西亚社会保障组织(SOCSO)于2007年推出了重返工作岗位(RTW)方案,这是一项综合性的多学科生物、心理和社会康复方案,针对因工作场所事故而残疾的投保人或声称残疾的投保人。这个康复计划是独一无二的,因为它涉及到“残疾管理”的概念,其中每个被提及该计划的投保人,都被分配给一个残疾案例经理,他在整个重返工作过程中积极参与。截至2013年12月,共有11,090名工人参与了SOCSO RTW计划,这需要许多工作流程,无数的文书工作和大量的物理文件和文件管理。由于这种巨大的信息流,需要一个更高效的信息系统。从一开始,整个想法就是创建一个可访问、快速和用户友好的应用程序。该应用程序现在被社会保障署的铁路运输部门用来管理他们的信息。这个应用程序建立在一个可以通过互联网访问的开源平台上。这也是一个“学习应用程序”,它使用其历史数据来帮助病例管理人员制定标准的康复计划,并预测可能的恢复工作结果。这种应用程序的优点在于它易于复制和配置(电子邮件通知、提醒等),以满足不同辖区的案例管理人员的需求。应用程序的范围也可以很容易地定义,以满足使用该应用程序的企业的规模。通过更好地管理信息,该应用程序减少了处理时间,减少了重复的文书工作,减少了存储面积,并在SOCSO的RTW案例管理系统中实现了几乎实时的信息流。除此之外,该应用程序现在还存储了丰富的信息,如各种残疾或疾病的康复策略或人口背景。
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引用次数: 1
Australia's National Injury Insurance Scheme - design, challenges and opportunities 澳大利亚国家伤害保险计划-设计,挑战和机遇
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/idm.2014.36
A. Fronsko
This presentation will focus on history and economic theory perspectives, using benchmark comparisons across Australian jurisdictions and leveraging materials in the public domain. The aim is to assist practitioners refine and manage their NIIS schemes for long term viability and customer/participant outcomes. The presentation will look at the Genesis of National Injury Insurance Schemes in Australia – a brief history of thinking that has shaped NIIS design, scheme Design model and rationale for a NIIS including Rationale for separating the NIIS and NDIS, What the “I” in NDIS really means, the Benchmark comparison of NDIS versus NIIS design feature and the staged approach to migrate to universal accident compensation. Moving on to exploring. NIIS Implementation Update - Motor Accident Compensation including a benchmark comparison - design models in 5 Australian CTP Jurisdiction. And finally a look at Insurance Claims Management vs Disability Management before speaking about the Next steps for NIIS and integration or possible alignment opportunities with the NDIS.
本演讲将侧重于历史和经济理论的观点,使用澳大利亚司法管辖区的基准比较,并利用公共领域的材料。目的是帮助从业者完善和管理他们的NIIS计划的长期可行性和客户/参与者的结果。本次演讲将着眼于澳大利亚国家伤害保险计划的起源——一个形成了NIIS设计的思想简史,NIIS的方案设计模型和基本原理,包括NIIS和NDIS分离的基本原理,NDIS中的“I”的真正含义,NDIS与NIIS设计特征的基准比较以及过渡到普遍事故赔偿的分阶段方法。继续探索。NIIS实施更新-交通事故赔偿,包括基准比较-澳大利亚5个CTP管辖区的设计模型。最后,在讨论NIIS的下一步以及与NDIS的集成或可能的对齐机会之前,看看保险索赔管理与残疾管理。
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引用次数: 0
Motivational Interactions: a client-centred engagement strategy in Australian accident compensation schemes 动机互动:澳大利亚事故赔偿计划中以客户为中心的参与策略
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/idm.2014.67
A. Papagiannis
Motivational interactions is based on the foundations of “Motivational interviewing” and the “Transtheoretical Model of Behaviour Change”, Which is widely recognised as an important engagement strategy for people working in a case management capacity- working with a range of injured client/worker needs pertaining to resistance, ambivalence to change, motivation, development and return to work. The quality of the working relationship between the worker and client is said to be a significant predictor of outcomes for a client. Evidence has indicated that a collaborative positive client centred engagement that is responsive to the change process of individuals is a reliable indicator of outcomes in a range of mental health, psychosocial and physical injury issues e.g. stress, depression, anxiety, physical injury, disability, with positive relationships being correlated with better Return to work/Life outcomes.
动机互动是建立在“动机访谈”和“行为改变的跨理论模型”的基础上的,这被广泛认为是一个重要的参与策略,对于从事案例管理工作的人来说,这是一种工作,与一系列受伤的客户/工人的需求有关,包括对改变的抗拒、矛盾心理、动机、发展和重返工作。工作人员和客户之间的工作关系的质量据说是一个重要的预测结果的客户。有证据表明,响应个人变化过程的以客户为中心的协作性积极参与是反映一系列心理健康、社会心理和身体伤害问题(如压力、抑郁、焦虑、身体伤害、残疾)结果的可靠指标,积极关系与更好的重返工作/生活结果相关。
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引用次数: 0
Challenges to disability management from an expanding fly-in fly-out workforce 不断扩大的飞进飞出劳动力对残疾管理的挑战
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/IDM.2014.49
H. Biggs
Australia's mineral, resource and infrastructure sectors continues to expand as operations in rural and remote locations increasingly rely on fly-in, fly-out or drive-in, drive-out workforces in order to become economically competitive. The issues associated with employing these workforces are becoming more apparent and include a range of physical, mental, psychosocial, safety, and community challenges. Research evaluating the impacts of fly-in, fly-out operations in Australia has been limited, and in February 2013 the Australian House of Representatives Standing Committee on Regional Australia made 21 recommendations aimed at improving these operations. To date, none of the recommendations have been implemented. The Construction and Mining sectors, in which most FIFO workers are employed, represent 12% of the total Australian workforce. Recent evidence from Safe Work Australia (2013) notes that serious injuries incident rates in both these sectors are well above the national injury rate. In addition the median payment and compensation cost for serious injury in these sectors are considerably higher than the Australian average due to higher employees salary, severity of incidents, lengths of absence from work, and medical expenses. These at risk remote site FIFO employees are further challenged post injury by lack of access to well-regarded disability management processes that have traditionally closely involved the workplace in the rehabilitation process. This paper examines the disparate challenges faced by both employers and employees in workplace wellbeing in remote sites, and raises questions as to how best disability management professionals can design, implement, and evaluate effective rehabilitation processes for injured FIFO workers who are a fast growing segment of the workforce but who work in conditions hitherto atypical of mainstream industry.
澳大利亚的矿产、资源和基础设施行业持续扩张,因为在农村和偏远地区的业务越来越依赖于“飞进、飞出”或“开车进、开车出”的劳动力,以提高经济竞争力。与雇用这些劳动力相关的问题正变得越来越明显,包括一系列身体、精神、社会心理、安全和社区挑战。在澳大利亚,评估飞进飞出业务影响的研究一直很有限,2013年2月,澳大利亚众议院澳大利亚地区常务委员会提出了21项建议,旨在改善这些业务。迄今为止,没有一项建议得到执行。建筑业和采矿业是采用先进先出法的工人最多的行业,占澳大利亚总劳动力的12%。来自澳大利亚安全工作协会(2013)的最新证据表明,这两个行业的严重伤害事件发生率远高于全国伤害发生率。此外,由于雇员工资较高、事故严重程度高、缺勤时间长和医疗费用高,这些部门严重伤害的支付和赔偿费用中位数远高于澳大利亚的平均水平。由于缺乏良好的残疾管理流程,这些处于危险的远程现场FIFO员工在受伤后面临进一步的挑战,而传统上,残疾管理流程与工作场所的康复过程密切相关。本文研究了雇主和雇员在偏远地区工作场所福利方面面临的不同挑战,并提出了关于最佳残疾管理专业人员如何为受伤的先进先出工人设计、实施和评估有效康复过程的问题,这些工人是劳动力中快速增长的一部分,但他们的工作条件迄今为止是非典型的主流行业。
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引用次数: 0
Navigating work disability paradigms and reform in Canada 加拿大的工作残疾模式和改革
Q1 Social Sciences Pub Date : 2014-11-12 DOI: 10.1017/idm.2014.13
E. Tompa
Objective: We investigate labour-market earnings of workers’ compensation claimants from three distinctly different workers’ compensation insurance support programs for claimants with permanent impairments. These three programs, which existed in Ontario, Canada in different periods over the last 25 years, are the Permanent Disability (PD) program, the Future Economic Loss (FEL) program, and the Loss of Earnings (LOE) program. The nature of benefit determination and the return to work supports provided by three programs are very different. The focus of the study is on evidence of programmatic impact on labour-market earnings recovery trajectories over nine years post injury. Methods: The study included claimants sampled from each of the three programs who sustained a permanent impairment from a work injury. Claimants were identified in a Revenue Canada tax file database known as the Longitudinal Administrative Databank (LAD), which is a longitudinal 20% simple random sample of all Canadian tax filers. Each claimant was matched with similar uninjured controls that were also in the LAD, based on sex, age, labour-market earnings amounts and trajectories in the four years prior to injury, and a propensity score. Statistical modeling analysis was undertaken to compare the labour-market earnings trajectories of claimants relative to their matched controls using data on earnings over the nine years post injury. Analyses focused on sub-strata defined by program, sex, age, permanent impairment level, and pre-injury earnings. A key issue of interest was to determine which program of supports resulted in the best labour-market earnings recovery. Results: Five distinct earnings recovery trajectories were identified. Claimants in various demographic and pre-injury earnings sub-strata from the LOE program cohort had a statistically significant lower probability of the lowest earnings recovery trajectory, and higher probability of the second highest trajectory compared to the PD cohort. Results for the LOE program were similar to the FEL program. Conclusions: Injured workers from the LOE program appear to fare better than claimants from the PD program and similarly to those from the FEL program in terms of labour-market earnings recovery over the nine years post injury. Across all programs, older claimants fare more poorly, and women fare worse than men in terms of labour-market earnings recovery.
目的:我们调查了三种截然不同的永久性损伤索赔人的工伤赔偿保险支持计划中工伤赔偿索赔人的劳动力市场收入。这三个项目在过去25年的不同时期存在于加拿大安大略省,分别是永久性残疾(PD)项目、未来经济损失(FEL)项目和收入损失(LOE)项目。三个项目提供的福利确定和重返工作岗位支持的性质非常不同。这项研究的重点是研究方案对受伤后9年内劳动力市场收入恢复轨迹的影响。方法:该研究包括从三个项目中取样的索赔人,他们因工伤而遭受永久性损害。申请人在加拿大税收档案数据库(称为纵向管理数据库(LAD))中确定,该数据库是所有加拿大税务申报人的纵向20%简单随机样本。根据性别、年龄、劳动力市场收入、受伤前四年的发展轨迹以及倾向评分,将每个索赔人与LAD中类似的未受伤对照进行匹配。利用受伤后9年的收入数据,进行统计建模分析,比较索赔人相对于其匹配对照的劳动力市场收入轨迹。分析集中在由项目、性别、年龄、永久性损伤水平和损伤前收入定义的底层。关心的一个关键问题是确定哪种支助方案最能使劳动力市场的收入恢复。结果:确定了五种不同的收益恢复轨迹。与PD组相比,LOE项目队列中不同人口统计和伤害前收入阶层的索赔人出现最低收入恢复轨迹的概率较低,而出现第二高收入恢复轨迹的概率较高。LOE方案的结果与FEL方案相似。结论:LOE计划的受伤工人似乎比PD计划的索赔人表现得更好,在受伤后九年的劳动力市场收入恢复方面,与FEL计划的索赔人相似。在所有项目中,年龄较大的申请人表现更差,在劳动力市场收入恢复方面,女性比男性表现更差。
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International Journal of Disability Management
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