ABSTRACT
Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.
Subject(s)
Delivery of Health Care , Germany , Insurance, Health , Japan , Korea , National Health Programs , Organisation for Economic Co-Operation and Development , Sick Leave , SwedenABSTRACT
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. .
Objective to estimate the prevalence of sickness benefits among workers in the construction industry and the potential influence of sex, age and branch of activity within the framework of incapacity for work in Brazil in 2009. Methods a cross-sectional population study based on sickness benefits provided by the Brazilian Social Security. Information about the branch of activity, sex, age, cause and type of clinical benefit of workers was extracted from the Unified Benefits and the National Registry of Social Information. The study population corresponded to the average monthly employment relations declared in 2009 (1,784,772). Results the study population was granted 81,235 sickness benefits, resulting in a prevalence of 455.2/10,000 bonds, predominantly non-work related benefits (Prevalence Ratio [PR] 3,1), male (PR 1,3), and branches of activity: Finishing works, Construction works of art and Earthwork. Men were granted 76.7% more sickness benefits related to work than women. The main causes were Injuries, Musculoskeletal Diseases, and Digestive Diseases. The most prevalent clinical categories were Back pain, Fracture at the wrist and hand, Fracture of the leg and Inguinal hernia. Prevalence increased with age. Conclusion the prevalence of sickness benefits was influenced by the type of benefit, type of activity, age and sex. The results of this study suggest potential mechanisms of underreporting/social security demand. .