Análisis de los criterios de valoración utilizados para casos de pensión vitalicia en un niño con Autismo. Reporte de un caso con enfoque médico legal / Analysis of the evaluation criteria used for life pension cases in a child with Autism. Report of a case with a forensic medical approach

El Trastorno del Espectro Autista (TEA), es trastorno del neurodesarrollo que se caracteriza por algún grado de dificultad en la interacción social y la comunicación, que comienza en el periodo de desarrollo temprano, y se clasifica según el grado de severidad en grado 1, 2 y 3, según lo establecido en el DSM-5. Dicho Trastorno se encuentra abarcado por la Ley 7125 de Pensión Vitalicia para Personas con Parálisis Profunda, y su reforma 8769. Con el objetivo de analizar los criterios establecidos para la valoración de estos procesos, se presenta el caso de una persona masculina de 6 años con diagnóstico de TEA, de quien se interpuso demanda para ser tomado en cuenta dentro de dicha Ley. En el mismo y tras el análisis respectivo, de acuerdo con los datos de la literatura científica actualizada, y de los criterios establecidos, se pudo constatar que si calificaba según lo indicado en la Ley 7125.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is characterized by some degree of difficulty in social interaction and communication, which begins in the early development period, and is classified according to the degree of severity in grade 1, 2 and 3, as established in the DSM-5. Said Disorder is covered by Law 7125 of Life Pension for people with deep cerebral palsy, and its reform 8769. In order to analyze the criteria established for the assessment of these processes, the case of a 6-year-old male person with diagnosis of ASD, of whom a lawsuit was filed to be taken into account within said Law. In it and after the respective analysis, according to the data of the updated scientific literature, and the established criteria, it was possible to verify that if qualified as indicated in Law 7125.

Maternidade e aposentadoria no RGPS: como as mulheres com filhos são afetadas pela reforma previdenciária da Emenda Constitucional 103/2019? / Motherhood and Retirement in the RGPS: How are Women with Children Affected by the Pension Reform of the Constitutional Amendment 103/2019? / Maternidad y jubilación en el RGPS: ¿cómo afecta a las mujeres con hijos la reforma previsional de la Enmienda Constitucional 103/2019?

Resumo Este trabalho analisa como a aposentadoria pode ser impactada pela maternidade, dado que pode afetar os fluxos de renda, contribuições e benefícios. Emprega-se um modelo atuarial com densidades contributivas diferenciadas por nível de renda. Como o número de contribuições varia em função destas densidades, a idade de aposentadoria é calculada de forma endógena, com a realização de um conjunto de simulações. Foram calculados cinco indicadores previdenciários em diferentes cenários, dados por combinações do evento da maternidade, idade no nascimento do filho, duração do afastamento do mercado de trabalho e salário no retorno ao mercado de trabalho. Os cálculos foram feitos para a regra antiga do Regime Geral de Previdência Social (RGPS), que vigorou até 2019, e para a regra nova, que passou a valer em 2020, após a aprovação da Emenda Constitucional n. 103/2019. Observou-se queda no caráter progressivo das aposentadorias do RGPS devido à reforma de 2019, bem como redução na maioria dos indicadores, particularmente na taxa interna de retorno. Mas a taxa de reposição pode aumentar para alguns grupos devido à extensão do período contributivo. Trabalhadoras sem filhos e aquelas que não deixam o mercado de trabalho devido à maternidade são afetadas de maneira razoavelmente similar pela reforma. Trabalhadoras que precisam deixar o mercado de trabalho são mais afetadas, com redução nos indicadores que dependem do período de recebimento do benefício de aposentadoria.

Abstract This paper analyzes how retirement can be affected by motherhood, as it can affect the flow of income, contributions and benefits, using an actuarial model with contribution densities differentiated by income level. As the number of contributions varies depending on these densities, retirement age is calculated endogenously, through a set of simulations. Five pension indicators were calculated in different scenarios, given by combinations of the motherhood event, age at birth of the child, duration of absence from the labor market and salary on return to the labor market. Calculations were made for the old rule of the RGPS, which was in force until 2019 and the new rule, which came into effect in 2020, after the approval of Constitutional Amendment 103/2019. There is a decrease in the progressive aspects of RGPS old-age benefits due to the 2019 reform. There is a reduction in most indicators, particularly in the internal rate of return. However, the replacement rate may increase for some groups due to the extension of the contribution period. Childless workers and those who do not leave the labor market due to motherhood are affected in a similar way by the reform. Workers who need to leave the labor market are more affected, with a reduction in indicators that depend on the period of receiving the retirement benefit.

Resumen Este artículo analiza cómo la maternidad puede afectar a la jubilación, ya que puede incidir en el flujo de ingresos, las cotizaciones y los beneficios. Se utiliza un modelo actuarial con densidades de cotización diferenciadas por nivel de ingresos. Como el número de cotizaciones varía en función de estas densidades, la edad de jubilación se calcula de forma endógena, mediante un conjunto de simulaciones. Se calcularon cinco indicadores de pensión en diferentes escenarios, dados por combinaciones del evento de maternidad, edad al nacimiento del hijo, duración de la ausencia del mercado laboral y salario al regreso al mercado laboral. Los cálculos se hicieron para la antigua regla de la RGPS, vigente hasta 2019, y la nueva regla, que entró en vigor en 2020 tras la aprobación de la Enmienda Constitucional 103/2019. Hay una disminución en los aspectos progresivos de las prestaciones de vejez del RGPS debido a la reforma de 2019, y una reducción en la mayoría de los indicadores, particularmente en la tasa interna de retorno, pero la tasa de reemplazo puede aumentar para algunos grupos debido a la extensión del período de contribución. Las trabajadoras sin hijos y las que no abandonan el mercado laboral debido a la maternidad se ven afectadas de manera razonablemente uniforme por la reforma. Las trabajadoras que necesitan salir del mercado laboral se ven más afectadas, con una reducción de los indicadores que dependen del período de percepción de la prestación por jubilación.

Benefícios Previdenciários: análise de afastamentos no Brasil decorrentes do distúrbio de voz / Social Security Benefits: analysis of sick leaves in Brazil due to voice disorders / Beneficios de la seguridad social: análisis de la licencia en Brasil, producto de trastornos de la voz

Introdução: o trabalhador brasileiro, quando adoece, pode recorrer a diferentes tipos de auxílios nas previdências pública e privada para garantir recursos para ele e sua família. Objetivo: descrever a concessão de benefícios previdenciários aos segurados que se afastam do trabalho por distúrbio de voz e de laringe no Brasil. Métodos: levantamento de dados secundários (Sistema Único de Informações de Benefícios), referentes aos afastamentos no período de 2009 a 2017. Foram considerados os CID-10: C32 - Neoplasia maligna da laringe; J04 - Laringite e traqueíte agudas; J37 - Laringite e laringotraqueíte crônicas; J38 - Doença das cordas vocais e da laringe não classificadas em outra parte - e R49 - Distúrbios da voz. Benefícios: B31- Auxílio-doença previdenciário, B32- Aposentadoria por invalidez previdenciária, B91- Auxílio-doença acidentário, B92- Aposentadoria por invalidez acidentária. Foram consideradas as variáveis: sexo, faixa etária e CID-10. Resultados: mulheres (59,6%), faixa etária entre 31 a 55 anos (58,4%) e CID C32 e J38 (68,8%) foram mais frequentes. Dentre os benefícios, o B31 (78,7%) e B32 (10,5%) foram os mais concedidos. Conclusão: observou-se predominância da concessão dos benefícios previdenciários (B31) por doença comum, na faixa etária entre 31 a 55 anos. As mulheres afastam-se predominantemente com os CID J38.2 e R49, e homens pelo CID C32.

Introduction: the Brazilian worker, in the presence of illness, can use different types of social security benefits to protect resources for him and his family. Objective: to describe the granting of social security benefits to policyholders who leave work due to voice and laryngeal disorders in Brazil. Methods: survey of secondary data (Single Benefit Information System), referring to sick leave from 2009 to 2017. ICD-10 was considered: C32 - Malignant neoplasm of the larynx; J04 - Acute laryngitis and tracheitis; J37 - Chronic laryngitis and laryngotracheitis; J38 - Disease of the vocal cords and larynx not elsewhere classified - and R49 - Voice disorders. Benefits: B31- Pension sickness benefit, B32- Retirement due to social security disability, B91- Accident sickness allowance, B92- Retirement due to accidental disability. Gender, age groups and ICD-10 variables were considered. Results: Women (59.6%), aged between 31 and 55 years (58.4%) and CID C32 and J38 (68.8%) were more frequent. Among the benefits, B31 (78.7%) and B32 (10.5%) were the most granted. Conclusion: there was a predominance of the granting of social security benefits (B31) due to common illness in the age group between 31 and 55 years old. Women distance themselves predominantly with ICD J38.2 and R49, and men with ICD C32.

Introducción: el trabajador brasileño, en presencia de enfermedad, puede utilizar diferentes tipos de prestaciones de seguridad social para proteger los recursos para él y su família. Objetivo: describir el otorgamiento de prestaciones de seguridad social a asegurados que dejan el trabajo por trastornos de la voz y laringe en Brasil. Métodos: encuesta de datos secundarios (Sistema Único de Información de Beneficio), referido a la baja laboral de 2009 a 2017. Se consideraron CIE-10: C32 - Neoplasia maligna de laringe; J04 - Laringitis y traqueítis agudas; J37 - Laringitis y laringotraqueítis crónica; J38 - Enfermedad de las cuerdas vocales y laringe no clasificada en otra parte - y R49 - Trastornos de la voz. Prestaciones: B31- Pensión por enfermedad, B32- Jubilación por invalidez de la seguridad social, B91- Subsidio por accidente, B92- Jubilación por invalidez accidental. Se consideraron las variables sexo, grupo de edad y CIE-10. Resultados: las mujeres (59,6%), con edades comprendidas entre 31 a 55 años (58,4%) y CID C32 y J38 (68,8%) fueron más frecuentes. Entre los beneficios, B31 (78,7%) y B32 (10,5%) fueron los más otorgados. Conclusión: predominó el otorgamiento de prestaciones de seguridad social (B31) por enfermedad común, en el grupo de edad entre 31 y 55 años. Las mujeres se distancian predominantemente con ICD J38.2 y R49, y los hombres con ICD C32.

Efeitos das aposentadorias por tempo de contribuição e por idade sobre saúde e bem-estar dos indivíduos no Brasil / Effects of retirement pensions according to contribution time and age on Brazilians' health and wellbeing / Efectos de las jubilaciones por tiempo de contribución y por edad sobre la salud y bienestar de los individuos en Brasil

Resumo: O processo de envelhecimento da população brasileira diante das diversidades de características populacionais e territoriais do país incentivou o estudo realizado acerca dos efeitos das aposentadorias sobre saúde e bem-estar. Nesse sentido, são analisados os efeitos das aposentadorias no Brasil por idade e tempo de contribuição por meio de medidas de saúde geral autoavaliada, sintomas depressivos da escala CES-D e rendas domiciliar e individual do responsável pelo domicílio. As análises também foram desagregadas por gênero e localidade. O método utilizado foi o Propensity Score Matching com dados de 9.412 indivíduos com 50 anos ou mais, obtidos do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), coletados nos anos de 2015 e 2016. Sobre a saúde geral autoavaliada, há aumento na probabilidade de avaliação da saúde como boa ou excelente para as mulheres da zona urbana, tanto para as que aposentaram por tempo de contribuição, em mais de 9%, como por idade, em mais de 7%. Há redução na probabilidade de presença de sintomas depressivos para as mulheres que aposentaram por tempo de contribuição em 11%, e, para homens da zona rural, há redução em mais de 16%. Já sobre a renda, os efeitos são de aumentos expressivos para todos os subgrupos. A pesquisa buscou contribuir para mitigar a escassez de evidências sobre efeitos das aposentadorias no Brasil, e, em geral, os resultados sugerem que os efeitos das aposentadorias sobre a saúde e o bem-estar dos indivíduos são benéficos, contudo, bastante heterogêneos entre homens e mulheres das zonas rural e urbana.

Abstract: Aging of the Brazilian population with the country's diversity of demographic and territorial characteristics motivated this study on the effects of retirement pensions on health and wellbeing. The study thus analyzes the effects of retirement pensions in Brazil by age and contribution time through measures of overall self-rated health, depressive symptoms on the CES-D scale, and household and head-of-household income. The analyses were also disaggregated by gender and locality. The method used was Propensity Score Matching with data from 9,412 individuals 50 years or older obtained from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), collected in the years 2015 and 2016. In overall self-rated health, there was an increase in the probability of rating health as good or excellent for women in urban areas, both for those retired by contribution time (more than 9%) and by age (more than 7%). There was a reduction in the probability of depressive symptoms for women that retired by contribution time (11%), while for men from rural areas there was a reduction of more than 16%. There were important increases in income in all the subgroups. The study aimed to help offset the lack of evidence on the effects of retirement pensions in Brazil, and the results generally suggest that the effects of retirement pensions on individuals´ health and wellbeing are beneficial but quite heterogeneous between men and women and between rural and urban areas.

Resumen: El proceso de envejecimiento de la población brasileña ante las diversas características poblacionales y territoriales del país incentivó el estudio realizado acerca de los efectos de las jubilaciones sobre salud y bienestar. En ese sentido, se analizan los efectos de las jubilaciones en Brasil por edad y tiempo de contribución, a través de medidas de salud general autoevaluadas, síntomas depresivos de la escala CES-D, rentas domiciliarias y la individual del responsable del domicilio. Los análisis también fueron desagregados por género y localidad. El método utilizado fue el Propensity Score Matching con datos de 9 412 individuos con 50 años o más, obtenidos del Estudio Brasileño Longitudinal de la Salud del Envejecimiento (ELSI-Brasil), recogidos durante los años de 2015 y 2016. Sobre la salud general autoinformada, existe un aumento en la probabilidad de evaluación de la salud como buena o excelente para las mujeres de la zona urbana, tanto para las que se jubilaron por tiempo de contribución, en más de un 9%, como por edad, en más de un 7%. Existe reducción en la probabilidad de presencia de síntomas depresivos para las mujeres que se jubilaron por un tiempo de contribución en un 11%, y, para hombres de la zona rural, existe reducción en más de un 16%. Ya sobre la renta, los efectos son de aumentos expresivos para todos los subgrupos. La investigación procuró contribuir a la escasez de evidencias sobre efectos de las jubilaciones en Brasil y, en general, los resultados sugieren que los efectos de las jubilaciones sobre la salud y el bienestar de los individuos son benéficos, no obstante, bastante heterogéneos entre hombres y mujeres de las zonas rurales y urbanas.

Renovación de las Pensiones Asistenciales No Contributivas en el año 2019 / 3 RENOVATION OF NON-CONTRIBUTIVE PENSIONS FROM THE YEAR 2019

Estudio Descriptivo. Análisis y comparación de las características de la población que concurrió al Servicio de Medicina Legal del Hospital Nacional A. Posadas, a renovar sus pensiones asistenciales a través de la confección del Certificado Médico Oficial Digital, en el año 2019, y comparándolas con las renovaciones a nivel nacional ocurridas en el año 2014

Descriptive Study. Analysis and comparison of the population´s characteristics who concur to the Legal Medicine Service at the National Hospital A. Posadas, to renovate their welfare pensions through the confection of the Digital Official Medical Certificate, year 2019, and comparing them with the national renovations which happened in 2014

Vulnerabilidade social e envelhecimento na América Latina. Uma revisão bibliográfica a partir das publicações da Comissão Econômica para a América Latina e o Caribe (CEPAL) / Social vulnerability and aging in Latin America. A bibliographic review of the publications of the Economic Commission for Latin America and the Caribbean (ECLAC) / Vulnerabilidad social y envejecimiento en América Latina. Una revisión bibliográfica de las publicaciones de la Comisión Económica para América Latina y el Caribe (CEPAL)

Com foco nas iniciativas de países da América Latina no enfrentamento à vulnerabilidade social da população idosa, realizou-se um estudo de revisão, no acervo online da Comissão Econômica para a América Latina e o Caribe ­ CEPAL. Reuniram-se 27 publicações, entre 2007-2017, discutidas quanto a sistemas de pensão, redes de apoio, políticas e programas sociais. As iniciativas são heterogêneas e decorrem, sobretudo, do grau de envelhecimento e do perfil socioeconômico de cada país.

With a focus on the initiatives of Latin American countries in confronting the social vulnerability of the elderly population, a review study was made in the collection of the Economic Commission for Latin America and the Caribbean-ECLACT, wenty-seven publications were discussed between 2007-2017 in relation to pension systems, support networks, policies and social programs. The initiatives are heterogeneous and are mainly due to the degree of aging and the socioeconomic profile of each country.

Con foco en las iniciativas de países de América Latina en el enfrentamiento a la vulnerabilidad social de la población anciana, se realizó un estudio de revisión, en el acervo on-line de la Comisión Económica para América Latina y el Caribe - CEPAL. Se reunieron 27 publicaciones, entre 2007/2017, discutidas en cuanto a sistemas de pensiones, redes de apoyo, políticas y programas sociales. Las iniciativas son heterogéneas y se derivan, sobre todo, del grado de envejecimiento y del perfil socioeconómico de cada país.

Estimating the Fiscal Costs of Osteoporosis in Korea Applying a Public Economic Perspective

BACKGROUND: Osteoporosis and attributable fractures are disruptive health events that can cause short and long-term cost consequences for families, health service and government. In this fracture-based scenario analysis we evaluate the broader public economic consequences for the Korean government based on fractures that can occur at 3 different ages.METHODS: We developed a public economic modelling framework based on population averages in Korea for earnings, direct taxes, indirect taxes, disability payments, retirement, pension payments, and osteoporosis health costs. Applying a scenario analysis, we estimated the cumulative average per person fiscal consequences of osteoporotic fractures occurring at different ages 55, 65, and 75 compared to average non-fracture individuals of comparable ages to estimate resulting costs for government in relation to lost tax revenue, disability payments, pension costs, and healthcare costs. All costs are calculated between the ages of 50 to 80 in Korean Won (KRW) and discounted at 0.5%.RESULTS: From the scenarios explored, fractures occurring at age 55 are most costly for government with increased disability and pension payments of KRW 26,048,400 and KRW 41,094,206 per person, respectively, compared to the non-fracture population. A fracture can result in reduction in lifetime direct and indirect taxes resulting in KRW 53,648,886 lost tax revenue per person for government compared to general population.CONCLUSIONS: The fiscal consequences of osteoporotic fractures for government vary depending on the age at which they occur. Fiscal benefits for government are greater when fractures are prevented early due to the potential to prevent early retirement and keeping people in the labor force to the degree that is observed in non-fracture population.

Perfil clínico-epidemiológico de los derechohabientes con tuberculosis del IHSS, Teguciglpa; período 2011-2016 / Clinical and epidemiological profile of rightholders with tuberculosis of IHSS, Tegucigalpa; period 2011-2016

Antecedentes: Las condiciones laborales de ciertas personas pueden favorecer la aparición de tuberculosis. Objetivo. Determinar la existencia de patrones ocupacionales entre derechohabientes con tuberculosis (TB), del Instituto Hondureño de Seguri-dad Social (IHSS) en Tegucigalpa y resultado del abordaje diagnóstico y tratamiento. Metodología. Estudio descriptivo, retrospectivo, en los derechohabientes del IHSS Tegucigalpa, con universo de 460,150; la muestra fueron todos los expedientes de personas con Tuberculosis del periodo 2011-2016 mayores de 18 años. Se obtuvo información de la base de datos, fichas de notificación, expediente clínico y libro de seguimiento, determinando ocupación, variables sociodemográficas y programáticas. Se analizaron frecuencias e intervalos de confianza utilizando Epi Info Versión 7.2. Se solicitó permiso al IHSS y se respetó la confidencialidad de datos. Resultados. Se encontró expedientes de 214 pacientes con tuberculosis siendo mujeres (113) 52.6% y hombres (101) 47.4%; (137) 64% presentaron tuberculosis pulmonar y (77) 36% con tuberculosis extrapulmonar. La situación laboral predominante fue la de los asalariados de ocupación no especificada (73/214) 34%, seguido de Jubilados (16/214) 7%, empleados de salud (12/214) 6%, vigilantes (5/214) 2% y empleados de maquila (5/214) 2%. El método diagnóstico más frecuente fue baciloscopia (127) 59%, tuvieron éxito de tratamiento (171) 80%, fallecieron (13) 6%, perdida de seguimiento (13) 6%. ConclusiónEs necesario diseñar estrategias de prevención y capacitación para diagnóstico y tratamiento oportuno en lugares de trabajo como compañías de vigilancia, maquila, escuelas y universidades, hospitales e investigar razones de excedo de fallecimientos y perdida de seguimiento de pacientes...(AU)

Factores determinantes para la vulnerabilidad económica a través del programa de pensiones 65 y más, en el estado de Nuevo León, Mexico / Determining factors for economic vulnerability through the 65 and more pension program, in the state of Nuevo León, Mexico / Fatores determinantes da vulnerabilidade econômica por meio do programa de aposentadorias dos 65 e mais anos, no estado de Nuevo León, México

El programa de pensiones para el adulto mayor en vulnerabilidad económica, plantean distintas variables para la obtención de beneficios; en el presente estudio empírico, se analizan los resultados descriptivos y se ejecuta un análisis factorial para conocer los factores determinantes para atender la vulnerabilidad económica, a través del programa de pensiones 65 años y más, en el estado de Nuevo León, Mexico.

Pension programs for the elderly in the economic alternative, raise different variables for obtaining benefits, in the present empirical study, the descriptive results are analyzed and a factor analysis is achieved to know the determining factors to address the economic vulnerability through of the pension program 65 and more, in the state of Nuevo León.

O programa previdenciário para idosos, em situação de vulnerabilidade econômica, eleva diferentes variáveis para obtenção de beneficios. No presente estudo empírico, os resultados descritivos são analisados e uma análise fatorial é realizada para determinar os fatores determinantes para abordar a vulnerabilidade econômica, através do programa de aposentadoria dos 65 e mais anos, no estado de Nuevo León, México.

Caracterización de factores relacionados con la reclamación y aprobación de pensiones de invalidez por enfermedad común en población trabajadora colombiana entre 2006-2011 / Characterization of factors related to the application for and approval of pensions due to common diseases among the Colombian working population, 2006-2011

RESUMEN Introducción: mientras la discapacidad afecta hasta el 12 % de la población de un país según fuentes oficiales en Colombia, a pesar del sub registro, tendrá un comportamiento creciente en los próximos años. Las Administradoras de Fondos de Pensiones (AFP) están encargadas del manejo eficiente del fondo para el riesgo pensional en Colombia. Objetivo: caracterizar la reclamación de pensiones de invalidez por enfermedad común y los principales factores relacionados con su aprobación entre 2006 y 2011 en una AFP colombiana. Materiales y métodos: la fuente secundaria de la información fue la AFP a través del Manual Único para la Calificación de Invalidez. Estudio descriptivo y exploratorio inferencial de factores relacionados con los desenlaces de invalidez, y aprobación de la solicitud pensional. Resultados: ser declarado inválido estuvo asociado con ser hombre, el máximo nivel de estudio, y la deficiencia dada por las causales de solicitud: enfermedades poco prevalentes pero muy incapacitantes. Tener soporte social disminuye la probabilidad de ser declarado inválido. Discusión y conclusión: los factores aquí relacionados con la invalidez acorde con otros estudios deben considerarse en la formulación de políticas públicas que puedan impactar en la prevención de este desenlace y el bienestar de la población trabajadora.

SUMMARY Introduction: According to official sources, disability affects up to 12 % of a country's population. In Colombia, however, this percentage will continue to increase in the coming years regardless of the existing under-recording. Additionally, Pension fund administrators (PFAs) are in charge of efficiently managing the pension risk fund in Colombia. Objective: To characterize disability pension applications due to common diseases along with the main factors regarding their approval between 2006 and 2011 in a Colombian PFA. Materials and Methods: The PFA's Unique Manual for Disability Assessment was used as a secondary source of information. This was a descriptive study with an inferential exploration of the factors concerning two outcomes: disability and application approval. Results: Being declared as a disabled person was associated with being male, having the highest schooling level, and the impairment motivating the application: diseases that have low prevalence but are very disabling. Having social support decreased the probability of being declared disabled. Discussion and conclusion: The factors related to disability, which are consistent with those reported by other studies, should be considered when proposing public policies, which may have an impact on the prevention of this outcome and the well-being of the working population.

Public social security burden of musculoskeletal diseases in Brasil-Descriptive study

SUMMARY BACKGROUND: To present data on the social security burden of diseases of the musculoskeletal system and connective tissue (DSOTC) in Brasil in 2014, and evolution of these social security expenditures between 2009 and 2014. METHOD: Compilation and analysis of data on the granting of disability pensions and sickness benefits in the year 2014, available on the official website of Social Security, classified according to ICD 10. It was evaluated the evolution between 2009 and 2014, using the F test to compare the curves with the growth of the active age population (PIA). RESULTS: Among the 22 disease groups classified according to ICD-10, the DSOTC group led benefits grants in 2014, with 19% of the sickness benefits and 13.5% of the disability pensions. The main causes of sickness benefit and disability retirement were, respectively: dorsopathies (43.3% and 41.2%), soft tissue diseases (27.3% and 19.7%), osteoarthritis (7.6% % And 27.8%) and chronic inflammatory arthropathies (2.8% and 7.9%). In the evolution of the number of sickness benefits granted between 2009 and 2014, both INSS and DSOTC totals showed an increasing tendency (35.9 and 35.3%, respectively, with p = 0.000 for both). As for disability retirement, there was a 5.9% increase in the INSS total (p = 0.039), while for the DSOTC there was a decrease of 7.6% (p = 0.005). CONCLUSIONS: These data point to a progressive increase in the granting of sickness pensions and disability benefits in the country, superior to the growth of the PIA, as well as a high participation of DSOTC in these benefits.

RESUMO OBJETIVOS: Apresentar dados sobre o ônus previdenciário das doenças do sistema osteomuscular e tecido conjuntivo (DSOTC) no Brasil no ano de 2014, e sua evolução entre 2009 e 2014. MÉTODO: Compilação e análise de dados sobre a concessão de aposentadorias por invalidez e auxílios-doença no ano de 2014 disponíveis no portal oficial da Previdência Social, classificados segundo o CID 10. Avaliação da evolução entre 2009 e 2014, utilizando-se o teste F para comparar as curvas com o crescimento da população em idade ativa (PIA). RESULTADOS: Entre 22 grupos de doenças classificados de acordo com o CID 10, o das DSOTC liderou as concessões de benefícios em 2014, com 19% dos auxílios-doença e 13,5% das aposentadorias por invalidez. As principais causas de concessão de auxílio-doença e aposentadoria por invalidez foram, respectivamente: dorsopatias (43,3% e 41,2%), doenças de partes moles (27,3% e 19,7%), osteoartrite (7,6% e 27,8%) e artropatias inflamatórias crônicas (2,8% e 7,9%). Na evolução do número de auxílios-doença concedidos entre 2009 e 2014, tanto o total do INSS quanto o do grupo DSOTC apresentaram tendência crescente (35,9 e 35,3%, respectivamente, com p = 0,000 para ambos). Já para aposentadoria por invalidez, houve aumento de 5,9% no total do INSS (p = 0,039), enquanto que para as DSOTC houve um decréscimo de 7,6% (p = 0,005). CONCLUSÕES: Verificou-se uma elevação progressiva na concessão de auxílio-doença e aposentadoria por invalidez no País, superior ao aumento da população em idade ativa. As DSOTC foram o grupo com maior participação relativa nesses benefícios.

Outcomes into Adulthood of Survivors Born Either Extremely Low Birthweight or Extremely Preterm

We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; < 1,000 g) or extremely preterm (EP; < 28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.

Factors associated with the receipt of pensions among older adults: ELSI-Brazil / Fatores associados ao recebimento de aposentadorias entre adultos mais velhos: ELSI-Brasil

ABSTRACT OBJECTIVE To describe the prevalence of receipt of pensions and associated factors in a nationally representative sample of the Brazilian population aged 50 years and over. METHODS We used data from 9,130 participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline survey. The outcome variable was receipt of pensions from any source. The exploratory variables were age, gender, residence by region and by urban/rural area, household arrangements, schooling, household assets, perception of income sufficiency, age when started working, number of chronic diseases, and functional limitation. The analyses were based on the Poisson and binary logistic regressions. RESULTS The prevalence of the receipt of pension was 54.3%. In the multivariate analysis, the following factors showed statistically significant (p < 0.05) associations with the outcome: age [Prevalence Ratio (PR) = 2.59 and 3.24 for 60-69 and 70 years], rural residence (PR = 1.23 ), residence in the Northeast, South and Southeast compared to the North (PR ranging from 1.18 to 1.23), living arrangements (PR = 1.07 and 1.15 for living with one person and living alone), perception of income sufficiency (PR = 1.08 and 1.15 for sometimes and always), functional limitation (PR = 1.13) and having 1 and ≥ 2 chronic diseases (PR = 1,09 and 1,17). Negative association was observed for 5-8 years of education. No association between age when the individual started working and the outcome was observed. Younger participants (50-59 years old) with ≥ 2 diseases or functional limitation were 31% and 63% more likely to receive pensions, respectively; the strength of these associations declined with age. CONCLUSIONS The results suggest that health conditions are important determinants of early retirement. Discussions to increase age to the retirement cannot be separated from those on improvements in the health conditions of the Brazilian population.

RESUMO OBJETIVO Descrever a prevalência do recebimento de aposentadorias e pensões e analisar seus fatores associados em amostra nacional da população com 50 anos ou mais. MÉTODOS Foram utilizados dados de 9.130 participantes da linha de base do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil). O desfecho foi o recebimento do benefício por qualquer fonte. As variáveis exploratórias incluíram: idade, sexo, residência por região e zona urbana ou rural, arranjos domiciliares, escolaridade, bens domiciliares, suficiência da renda, idade em que começou a trabalhar, número de doenças crônicas e limitação funcional. As regressões de Poisson e logística binária foram utilizadas nas análises. RESULTADOS A prevalência do recebimento do benefício foi de 54,3%. Na análise multivariada, os seguintes fatores apresentaram associações significantes (p < 0,05) com o recebimento do benefício: idade [razão de prevalência (RP) = 2,59 e 3,24 para 60-69 e 70 anos], residência rural (RP = 1,23), residência no Nordeste, Sul e Sudeste em comparação ao Norte (RP variando entre 1,18 e 1,23), arranjos domiciliares (RP = 1,07 e 1,15 para morar com uma pessoa e para morar só), percepção da suficiência da renda (RP = 1,08 e 1,15 para às vezes e sempre suficiente), ter doenças crônicas (RP = 1,09 e 1,17 para 1 e ≥ 2) e limitação funcional (RP = 1,13). Associação negativa foi observada para escolaridade igual a 5-8 anos (RP = 0,88). O recebimento do benefício não foi associado com a idade em que começou a trabalhar. Participantes mais jovens (50-59 anos) com ≥ 2 doenças crônicas ou limitação funcional foram 31% e 63% mais propensos a receber o benefício. Com o aumento da idade, a força dessas associações diminuiu. CONCLUSÕES Os resultados sugerem que as condições de saúde são importantes determinantes da aposentadoria ou pensão precoce. As discussões para aumentar a idade da aposentadoria não podem ser separadas daquelas acerca de melhorias das condições de saúde da população brasileira.

The Process of Compensation of Occupational Diseases in Special Populations: Public Officials, Private School Teachers and Staff, Soldiers, Fishing Crews, and Farmers

OBJECTIVE: The purpose of this study was to review the compensation and development direction of occupational accidents including occupational diseases of workers who do not apply industrial accident compensation insurance. METHODS: We reviewed laws and related articles about compensation for occupational accidents of public officials, private school teachers and staff, soldiers, fishermen, and farmers, and compared each system and presented problems and solutions. RESULTS: Public officials, private school teachers and staff, and soldiers were provided compensation for the occupational accidents by the state in the form of pensions. Safety accident insurance for farmers was a form of voluntary subscription, but the individual had to pay the remaining premiums even though there were over half of the national burden. Although there were differences in the degree of professionalism in approval system of occupational accidents in the fields of public officials, private school teachers and staff, and soldiers, there was a deliberative body composed of experts, but fishermen and farmers were in fact considering deliberations on the compensation of insurance companies. Like the industrial accident compensation insurance, the prevention fund was not legally enforced in all fields. CONCLUSION: Processes for compensation for occupational accidents was somewhat similar. However, scientific and rational deliberations were difficult to achieve consistently. There was a lack of systems to prevent disasters and institutionalize rehabilitation for returning to work after a disaster. It is necessary to introduce a consistent system for reasonable compensation, disaster prevention, and return to work according to the risk level of the special population.

An overview of compensated work-related injuries among Korean firefighters from 2010 to 2015

BACKGROUND: Although one in two firefighters in South Korea have experienced work-related injuries, there are few studies which show the overview description on work-related injuries and its analysis regarding such causes. Therefore, we aimed to show the overview of compensated work-related injuries in order to serve fundamental data for establishing prevention policies on work-related injuries for Korean firefighters. METHODS: We requested the all claimed work-related injury data of Korean firefighters from 2010 to 2015 to the Korean National Fire Agency (NFA). The data from NFA including 2457 claimed cases was analyzed and we confirmed, 2154 approved work-related injuries for the kinds of job activities, cause of accident and type of injuries. Among 2154 approved cases, we analyzed more variables for the sex, age, and job duration of 1344 compensated cases through served text file on summary of accident. RESULTS: The Government Employees Pension Service (GEPS) recognized 2154 (87.7%) approved work-related injuries among 2457 claimed cases. The incidence of work-related injuries per 1000 firefighters was 9.8 persons. By region, the incidence of work-related injuries per 1000 firefighters ranged from a maximum of 14.5 to a minimum of 4.0. The most common job activity caused the accident was fire suppression (18.0%), followed by Emergency medical services (EMS) (17.5%) and training (10.7%). The most common cause of these accident was movement imbalance (30.3%), followed by falls (18.9%) and traffic accident (13.4%). In these work-related injuries, sprains and bruises were the most common type of injury (27.2%), and the most commonly injured body site was the upper and lower back (25.3%). Data from identified 1344 firefighters showed that 1264 (94.0%) were male and 80 (6.0%) were female. Age group was the highest in the 40s with 623 cases (46.4%), and job duration was the highest with 650 cases in 5–10 years (48.4%). CONCLUSION: In this study, we could obtain the preliminary data necessary to establish preventive measures, including the cause of accident and region with high accident rates. However, the number of applications for compensated injuries was very small compared to the frequency of injuries found in previous studies. The lack of appropriate treatment suggested that many firefighter injuries can become chronic. In this study, we suggest that it is necessary to introduce an injury monitoring system and improve the accessibility of compensated injuries. TRIAL REGISTRATION: CR318031. Registered 20 June 2018.

Lack of Retirement Preparation is Associated with Increased Depressive Symptoms in the Elderly: Findings from the Korean Retirement and Income Panel Study

The aim of this study was to investigate the relationship between retirement preparation and depressive symptoms among Koreans 50 years of age or older. We used data from the 2009 to 2013 Korean Retirement and Income Panel Study (KReIS), which included data from the 365 baseline participants of 50 years of age or older. Our sample included only newly retired participants who worked in 2009, but had retired in the 2011 and 2013. To monitor the change in depressive symptoms according to retirement preparation, we used repeated measurement data. We measured depressive symptoms using the Center for Epidemiological Studies Depression (CES-D) 20-item scale. In addition, we measured retirement preparation using a single self-report question asking whether the participant was financially ready for retirement. We evaluated relationship between retirement preparation and depressive symptoms after multivariable adjustment. Compared to subjects who had prepared for retirement (reference group), participants who had not prepared for retirement had increased depression scores (β = 2.49, P < 0.001). In addition, individuals who had not prepared for retirement and who had low household income had the highest increase in depression scores (β = 4.43, P < 0.001). Individuals, who had not prepared for retirement and without a national pension showed a considerable increase in depression scores (β = 3.02, P < 0.001). It is suggested that guaranteed retirement preparation is especially important for mental health of retired elderly individuals with low economic strata.

Accidentes de trabajo y enfermedades laborales en los sistemas de compensación laboral / Work accidents and occupational diseases in work compensation systems

Introducción: Las contingencias laborales constituyen un importante problema de salud pública en el mundo. Para reducir los daños, los países han introducido leyes y normas técnicas para la prevención de las mismas y reparación de las víctimas a través de seguros de compensación laboral y atención médica integral. Objetivo: Conocer el nivel de evidencia existente sobre los accidentes de trabajo y enfermedades profesionales compensados y las características de los trabajadores que los presentaron e industrias más afectadas. Métodos: Se realizó una revisión sistemática bajo la metodología "Prisma". La búsqueda bibliográfica se llevó a cabo en bases de datos y revistas científicas a través de palabras claves que fueron combinadas y restringidas a artículos publicados entre los años 2003 y 2013. Resultados: Se incluyeron 11 artículos de investigaciones que fueron realizadas en cuatro continentes: Europa, Asia, Oceanía y América. Los tipos de estudios fueron, principalmente, retrospectivos con fuentes secundarias. Las muestras variaron entre 307 hasta 1.320.792 registros en diferentes grupos poblacionales, que tuvieron una o múltiples reclamaciones de compensación por accidentes de trabajo y/o enfermedades laborales. El género masculino tuvo el porcentaje más alto de reclamaciones; las industrias más afectadas fueron la manufactura y la construcción; predominaron como primera causa los esguinces o torceduras, seguidos por los trastornos musculoesqueléticos. Conclusiones: Las investigaciones revisadas proporcionan informaciones para caracterizar las contingencias ocupacionales y orientar las estrategias de prevención en las industrias y en las poblaciones trabajadoras más afectadas. Sin embargo, tienen limitaciones para establecer la gravedad de las lesiones y los tipos de compensación otorgados.

Introduction: Occupational injuries constitute an important problem of public health in the world. In order to reduce damage, countries have introduced laws and technical standards for their prevention, and to provide the victims support by means of worker's compensation insurance and comprehensive health care. Objective: To know the existing evidence level of work accidents and compensated occupational diseases and the characteristics of workers who presented them, and the most affected branches of industries. Methods: A systematic review following the "Prisma" methodology was conducted. The bibliographic research was carried out in databases and scientific journals through keywords that were combined and restricted to articles published between 2003 and 2013. Results: Eleven articles about researches conducted in four continents (Europe, Asia, Oceania and America) were included. The studies were mainly retrospective with secondary sources, and the samples ranged from 307 to 1,320,792 records in different population groups, who had one or multiple claims of compensation for work-related accidents or illnesses. The male gender had the highest percentage of claims; the most affected industries were manufacture and construction; the first causes were sprains and strains followed by musculoskeletal disorders. Conclusions: The reviewed investigations provide information to characterize the occupational contingencies and to orient the strategies of prevention in the industries and in the most affected working population. However, there are limitations to establish the seriousness of the injuries and the types of compensation awarded.

Estimating the indirect costs associated with the expected number of cancer cases in Mexico by 2020 / Estimación del costo indirecto asociado con el número esperado de casos de cáncer en México al año 2020

Abstract Objective: To estimate the indirect costs generated by adults with cancer in Mexico from 2002-2020. Materials and methods: Using information from national sources and the national cancer incidence from GLOBOCAN, we estimated income lost due to premature death (ILPD), short-term benefits (STBs), disability pensions (DPs), and opportunity costs for the carer (OCCs) generated by patients with cancer. Amounts were reported in Mexican pesos. Results: We estimated 23 359 deaths and 216 679 new cases of cancer by 2020, which would be associated with a total indirect cost of 20.15 billion Mexican pesos. Men are expected to generate 54.9% of these costs. ILPD is expected to comprise the highest percentage of the cost (60%), followed by OCCs (22%), STBs (17%) and DPs (1%). Conclusions: From an economic perspective, the results emphasize the need to strengthen preventive interventions and early detection of cancer among adults to reduce its effect on the productivity of Mexico.

Resumen Objetivo: Estimar el costo indirecto generado por población mexicana adulta con cáncer en el periodo 2002-2020. Material y métodos: Utilizando información 2002-2013 de fuentes nacionales y de incidencia de GLOBOCAN, se estiman para 2002-2020 los ingresos perdidos por muerte prematura (IPMP), subsidios de corto plazo (SCP), pensiones de invalidez (PD) y costo de oportunidad del cuidador (COC) generados por pacientes con cáncer, reportándose montos en millones de pesos (mdp) mexicanos. Resultados: Se estiman 23 359 muertes y 216 679 casos nuevos de cáncer para 2020, con un costo indirecto total de 20 148 mdp, del cual 54.9% corresponde a hombres. IPMP contribuye en mayor medida (60%), seguida por COC (22%), SCP (17%) y PD (1%). Conclusiones: Los resultados apoyan, desde la perspectiva económica, la necesidad de robustecer el proceso de prevención y detección temprana de los cánceres en adultos para reducir su impacto en la productividad del país.

Influence Factors on Health and Medical of Retirees Expense to Public Pension Recipients / 보건행정학회지

BACKGROUND: This study aims to identify the monthly average medical expenses of public pension recipients, and analyze the determinants of total health and medical expenses and Western and Oriental medicine expenses, medical service expenses, and medical supplies expenses. METHODS: This study used the fifth year data of 2013 out of the raw data of the Korean Retirement and Income Study collected by the National Pension Research Institute. This study conducted t-test, analysis of variance, and linear regression to verify publicly the relevance between pension recipients' general characteristics and health and medical expenses status using IBM SPSS ver. 21.0 for data analysis. RESULTS: It was analyzed that there is a difference in the spending of expenditure and health care costs according to public pension recipients. Medical expenses of the national pensioners was higher compared to the special corporate pensioners. The national pensioner is related expenditure size, education level, family members living together, residential areas, status of spouse, number of chronic illness, and status of limitation in daily life with psychological health status. CONCLUSION: Therefore, fairness does not occur fire to the medical use between the special corporate pensioners and national pensioners, aggressive of government such as health policy and financial support for the retiree pension policy that reflects the reality intervention would be required.