Principles of social security and health insurance for farmers in Poland and Germany--a comparative assessment.

INTRODUCTION AND OBJECTIVE: As landowners occupied with agricultural production comprise a sizeable part of the populations in mid- and western European countries, it seemed reasonable to assess the organization of health care systems concerning farmers and their families in Poland and Germany. Both countries have similar geographical conditions and rural environments. It so happens that in Poland the principles of the system of agricultural insurance (KRUS) is based on the experiences of Germany and France. STATE OF KNOWLEDGE: Basically, both in Poland and Germany, the agricultural health insurance companies provide the same insurance cover as other health insurance companies. In both countries, under certain conditions, in the case of illness, the insured farmers receive instead of sickness benefit operational assistance and home help. In spite of the similarities that characterize both administrations, many particular differences are to be noted, e.g. the farmers' social insurance in Poland is subject to only one ministry, in contrast to Germany where two ministries are responsible for farmers' social insurance. In Poland, KRUS is a monopolistic organization, whereas in Germany, nine similar independent structures fulfil the task of a health insurance company. Needless to say, many more funds are available for prevention, treatment and rehabilitation in Germany than in Poland, due to obvious differences in the overall national income.

Design and quality of ICF-compatible data items for national disability support services.

PURPOSE: To examine the structure, distribution and interrelationships of International Classification of Functioning, Disability and Health (ICF)-compatible items in Australia's national data collection about disability support services. METHOD: Rasch analyses were carried out on 93,000 records relating to people aged 15 to 64 years, receiving disability support services in Australia in 2003. The range of disabilities and services received was diverse. 'Support needs', in all nine life areas based on the ICF Activities and Participation domains, are recorded in the national data collection in one of the following three categories: 'needs no help/supervision in this life area'; 'sometimes needs help/supervision'; or 'always needs help/supervision or unable to do activity'. RESULTS: The results of the analysis demonstrate the value of the 'support needs' questions. The three categories of need for support were distinct and widely separated; the ICF domains were also found to be distinct. The results also showed that 'support needs' in one subset of ICF Activities and Participation domains could not be used to predict values in another subset. CONCLUSIONS: The two-dimensional question about 'support needs' offers promise as a general data capture tool for indicating 'extent' of disability. Caution should be exercised in the omission of any ICF Activities and Participation life areas for measurement in diverse populations.

Disability income insurance: the private market and the impact of genetic testing.

This article discusses the disability insurance industry in order to provide context regarding the potential impact of genetic testing on disability insurance. It describes disability income insurance, exploring both the protection it offers and its main contract provisions. It goes on to describe the private insurance market and the differences between group and individual insurance, and concludes with implications of genetic testing with respect to the private disability insurance market.

Estudio de las Barreras Arquitectónicas para las Personas con discapacidad dentro del Centro Histórico Cultural de la ciudad de Santa Cruz de la Sierra / Study of the Architectural barriers to the people with Disability within the Historical Center Cultural of the city of Santa Cruz de la Sierra

Contenido: 3. Marco Teorico, 3. 1 Definición, 3. 2 Situación actual, 3. 3 un asunto de inclusión, 3. 4 Mas alla de la media, 3. 5 Ampliación del ámbito, 3. 6Integración Natural de las necesidades, 3. 7 Diseño universsal, 3. 8 Cualquier persona, 3. 9 Independencia, 3. 10Normalidad, 3. 11 Vistabilidad y adaptabilidad, 3. 12 Requisitos en el entorno construido, 3. 13 Salud y Seguridad, , 3. 14 Qué representan los criterios, 3. 15 Accesibilidad, 3. 16 Obstáculo en nuestro entorno diario, 3. 17 Marco institucional. 4. Hipotesis. 5 Diseño metodologico. 6 Resultados. 7 Conclusiones

Use of an artificial neural network (ANN) for classifying nursing care needed, using incomplete input data.

BACKGROUND: In German nursing insurance, the act of classifying the client into four categories of disability is based on legally defined distinct criteria. When classifying deceased persons it is often impossible to collect all the required information. PRIMARY OBJECTIVE: We aimed to determine the ability of an artificial neural network (ANN) to calculate the category of disability, to investigate the response of the ANN to input items of different nature, quantity and data quality, and to estimate the minimum number of training data required. RESEARCH DESIGN: The investigation was conducted as a retrospective observational study. METHODS AND PROCEDURES: The analysis was based on routine records of 14000 adult clients of the nursing insurance. Several ANNs were trained, varying nature, number and quality of the input items as well as the size of the training data set. Each ANN's classification competence was tested on independent validation data, judging the ANN's conformance to the result of the individual expert assessment, using kappa statistics. MAIN RESULTS: Fed with all 30 input items available, the net classified 80% of cases correctly (weighted kappa = 0.78). Using three input items, weighted kappa was 0.63. Severe misclassification (deviation by more than one category in either direction) ranged between 0.2% (all 30 input items) and 3.7% (3/30 items). The less complete the individual input items were, the less accurate was the net's estimate. A 20% rate of missing values was well tolerated. A training set comprising 500 cases was adequate. CONCLUSIONS: The input item set inherits redundancy. The ANN's ability to correctly respond to subsets of input items makes it a powerful tool in quality control. In the categorization of deceased persons when only an incomplete input item set is available, the ANN can achieve satisfactory results.