RESUMO
The following guidelines were developed for the medical assessment services of the German pension fund. Starting from day-to-day practice, criteria and attributes to guide decisions for a systematisation of the sociomedical assessment of performance in diseases of the liver and the bile ducts were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent, e. g., for the assessment of applications for decreased earning capacity benefits. The guidelines summarise the typical manifestations of diseases of the liver and the bile ducts and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions, the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual. The guidelines followed from an extended procedure to attain a wide consensus in the setting of the German Pension Fund and an upgraded evidence base.
Assuntos
Doenças Biliares/diagnóstico , Doenças Biliares/terapia , Atenção à Saúde/normas , Hepatopatias/diagnóstico , Hepatopatias/terapia , Garantia da Qualidade dos Cuidados de Saúde/métodos , Garantia da Qualidade dos Cuidados de Saúde/normas , Doença Crônica , Alemanha , Humanos , Fatores SocioeconômicosRESUMO
The following guidelines were developed for the medical assessment services of the German Pension Insurance Federal Institution. Starting from day-to-day practice, criteria and attributes to guide decisions for a systemisation of the sociomedical assessment of performance in breast cancer were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent, e. g., for the assessment of applications for decreased earning capacity benefits. The guidelines summarise typical manifestations of breast cancer and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions, the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual.
Assuntos
Neoplasias da Mama/classificação , Neoplasias da Mama/diagnóstico , Avaliação da Deficiência , Indicadores Básicos de Saúde , Guias de Prática Clínica como Assunto , Medicina Social/métodos , Avaliação da Capacidade de Trabalho , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/reabilitação , Definição da Elegibilidade/normas , Alemanha/epidemiologia , Humanos , Medicina Social/organização & administraçãoRESUMO
The following guidelines were developed for the medical assessment services of the German Federal Insurance Institute for Salaried Employees (BfA). Starting from day-to-day practice, criteria and attributes to guide decisions for a systemization of the sociomedical assessment of performance in inflammatory bowel disease (Crohn's disease, ulcerative colitis) were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent -- e. g. for the assessment of applications for decreased earning capacity benefits. The guidelines summarise typical manifestations of inflammatory bowel disease and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual.
Assuntos
Avaliação da Deficiência , Guias como Assunto , Doenças Inflamatórias Intestinais/classificação , Doenças Inflamatórias Intestinais/diagnóstico , Índice de Gravidade de Doença , Avaliação da Capacidade de Trabalho , Adolescente , Adulto , Idoso , Alemanha , Humanos , Doenças Inflamatórias Intestinais/reabilitação , Masculino , Pessoa de Meia-Idade , Classe SocialRESUMO
The following guidelines were developed for the medical assessment services of the German Federal Insurance Institute for Salaried Employees (BfA). Starting from day-to-day practice, criteria and attributes to guide decisions for a systemisation of the sociomedical assessment of performance in chronic obstructive pulmonary diseases (COPD) and bronchial asthma were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent - e. g. for the assessment of applications for decreased earning capacity benefits. Part II outlines assessment of the individual's capacity, taking occupational factors into account. Following the determination of dysfunctions the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual.
Assuntos
Asma/diagnóstico , Asma/reabilitação , Avaliação da Deficiência , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação de Resultados em Cuidados de Saúde/normas , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/reabilitação , Asma/classificação , Alemanha , Humanos , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/normas , Guias de Prática Clínica como Assunto/normas , Doença Pulmonar Obstrutiva Crônica/classificação , Reabilitação Vocacional/métodos , Reabilitação Vocacional/normas , Resultado do TratamentoRESUMO
The following guidelines were developed for the medical assessment services of the German Federal Insurance Institute for Salaried Employees (BfA). Starting from day-to-day practice, criteria and attributes to guide decisions for a systematization of the sociomedical assessment of performance in chronic obstructive pulmonary diseases (COPD) and bronchial asthma were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent - e. g. for the assessment of applications for decreased earning capacity benefits. Part I of the guidelines gives information on the classification of chronic obstructive pulmonary diseases (COPD) and bronchial asthma and on the number of pensions due to limited earning capacity. The guidelines summarise typical manifestations of chronic obstructive pulmonary diseases (COPD) and bronchial asthma and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated.
Assuntos
Asma/diagnóstico , Avaliação da Deficiência , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Adulto , Asma/classificação , Asma/reabilitação , Gasometria , Broncoscopia , Diagnóstico Diferencial , Ecocardiografia , Ecocardiografia Doppler , Eletrocardiografia , Definição da Elegibilidade , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Pletismografia , Pletismografia de Impedância , Guias de Prática Clínica como Assunto , Doença Pulmonar Obstrutiva Crônica/classificação , Doença Pulmonar Obstrutiva Crônica/reabilitação , Testes de Função Respiratória , Fatores de Risco , Previdência Social/legislação & jurisprudência , Espirometria , Organização Mundial da SaúdeRESUMO
The following guidelines were developed for the medical assessment services of the German Federal Insurance Institute for Salaried Employees (BfA). Starting from day-to-day practice, criteria and attributes to guide decisions for a systemisation of the sociomedical assessment of performance in discopathy or associated diseases were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent -- e. g. for the assessment of applications for decreased earning capacity benefits. The guidelines summarise typical manifestations of discopathy or associated diseases and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual. Guidelines for the sociomedical assessment of performance in coronary heart disease (CHD) have been published in Gesundheitswesen 2002, 64: 451-465.
Assuntos
Avaliação da Deficiência , Guias como Assunto , Deslocamento do Disco Intervertebral/classificação , Avaliação da Capacidade de Trabalho , Vértebras Cervicais , Diagnóstico Diferencial , Definição da Elegibilidade/legislação & jurisprudência , Prova Pericial/legislação & jurisprudência , Alemanha , Humanos , Deslocamento do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/reabilitação , Vértebras Lombares , Exame Neurológico , Prognóstico , Previdência Social/legislação & jurisprudênciaRESUMO
The following guidelines were developed for the medical assessment services of the German Federal Insurance Institute for Salaried Employees (BfA). Starting from day-to-day practice criteria and attributes to guide decisions for a systemisation of the sociomedical assessment of performance in coronary heart disease (CHD) were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent - e.g. for the assessment of applications for decreased earning capacity benefits. The guidelines summarise typical manifestations of CHD and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination and for diagnostic tests - especially of myocardial functioning - are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally inferences are drawn regarding the occupational capacity of the individual.
Assuntos
Doença das Coronárias/diagnóstico , Avaliação da Capacidade de Trabalho , Doença das Coronárias/classificação , Doença das Coronárias/reabilitação , Prova Pericial/legislação & jurisprudência , Alemanha , Humanos , Guias de Prática Clínica como Assunto , Reabilitação Vocacional , Previdência Social/legislação & jurisprudênciaRESUMO
One hundred and fifty-four male and 69 female Chinese patients, aged between 40 and 60 years, who had suffered myocardial infarction (MI) were investigated and compared with 216 men and 219 women who had no history or ECG evidence of coronary heart disease. The male MI patients had significantly raised levels of triglycerides (160 mg/dl), cholesterol (194 mg/dl), VLDL-CH (31 mg/dl), apolipoprotein B (122 mg/dl) and apolipoprotein E (4.7 mg/dl) and a lower apolipoprotein A-I level (126 mg/dl) than the control group (triglycerides 131, cholesterol 179, VLDL-CH 26, apo B 102, apo E4.2, and apo A-I 138 mg/dl). The women with MI also had higher values for the atherogenic lipids than the control group (triglycerides 175 vs. 134 mg/dl, cholesterol 218 vs. 186 mg/dl, LDL-CH 128 vs. 104 mg/dl, VLDL-CH 32 vs. 26 mg/dl, apo B 121 vs. 103 mg/dl and apo E 5.4 vs. 4.3 mg/dl), as well as lowered apolipoprotein A-I (128 vs. 144 mg/dl). The Lp(a) levels (men and women considered together) were significantly higher for the MI patients (34.3 mg/dl vs. 26.2 mg/dl). Anti-atherogenic lipoproteins such as HDL-cholesterol, HDL2-CH, HDL3-CH, phospholipids and apolipoprotein A-II, C-II and C-III showed no difference between the groups.