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      Disability due to mental illness: social security benefits in Brazil 2008-2011

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          Abstract

          This communication aimed to analyze the profile variation of disability benefits due to mental disorders. Secondary data published by Brazilian Social Security between 2008 and 2011 were evaluated. Mean annual variation rates over the period were calculated for the economically active population, as were the number insured, paid out overall sickness benefits and for mental and behavioral disorders. Mental disorders are the third most common reason for disability benefits. There was an average annual increase of 0.3% in new benefit claims, with a 2.5% fall in mean annual incidence. Work-related disease was identified in 6.2% of cases, most of it due to mood disorders. The government should use the data from the Social Security Institute to support a debate of public policies regarding mental health.

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          Predicting the duration of sickness absence for patients with common mental disorders in occupational health care.

          This study attempted to determine the factors that best predict the duration of absence from work among employees with common mental disorders. A cohort of 188 employees, of whom 102 were teachers, on sick leave with common mental disorders was followed for 1 year. Only information potentially available to the occupational physician during a first consultation was included in the predictive model. The predictive power of the variables was tested using Cox's regression analysis with a stepwise backward selection procedure. The hazard ratios (HR) from the final model were used to deduce a simple prediction rule. The resulting prognostic scores were then used to predict the probability of not returning to work after 3, 6, and 12 months. Calculating the area under the curve from the ROC (receiver operating characteristic) curve tested the discriminative ability of the prediction rule. The final Cox's regression model produced the following four predictors of a longer time until return to work: age older than 50 years [HR 0.5, 95% confidence interval (95% CI) 0.3-0.8], expectation of duration absence longer than 3 months (HR 0.5, 95% CI 0.3-0.8), higher educational level (HR 0.5, 95% CI 0.3-0.8), and diagnosis depression or anxiety disorder (HR 0.7, 95% CI 0.4-0.9). The resulting prognostic score yielded areas under the curves ranging from 0.68 to 0.73, which represent acceptable discrimination of the rule. A prediction rule based on four simple variables can be used by occupational physicians to identify unfavorable cases and to predict the duration of sickness absence.
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            O mundo contemporâneo do trabalho e a saúde mental do trabalhador

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              Acidentes de trabalho no Brasil: prevalência, duração e despesa previdenciária dos auxílios-doença

              RESUMO OBJETIVO: estimar a prevalência, a duração e a despesa previdenciária dos benefícios de Auxílio-Doença por Acidente do Trabalho (ADAT) pagos pelo Instituto Nacional do Seguro Social (INSS) aos segurados empregados no Brasil em 2008. MÉTODO: As variáveis ADAT foram estratificadas segundo sexo, idade e agravos categorizados em capítulos da CID-10. RESULTADO: foram concedidos 306.908 ADAT com prevalência de 94,2 por 10.000 vínculos. Os agravos mais prevalentes foram os do capítulo XIX - Lesões, envenenamento e algumas outras consequências de causas externas, do XIII - Doenças do sistema osteomuscular e do tecido conjuntivo, e do V - Transtornos mentais e comportamentais. A prevalência dos benefícios foi maior no sexo masculino (111,2) e na faixa etária ≥ 40 anos (116,9). A duração média foi de 75 ± 64 dias e a despesa média de R\(2.181,00 ± 2.769,00, sendo maior para o Capítulo II - Neoplasias (R\) 5.083,00 ± 5.702,00). A despesa-dia média foi R\(29,00 ± 18,00, sendo superior para o Capítulo V (R\) 39,00 ± 23,00). A idade ≥ 40 anos apresentou maior prevalência, duração e despesa entre todos os capítulos, à exceção do XIX, que foi o mais prevalente entre os mais jovens. CONCLUSÃO: os dados de ADAT são sugestivos de subcaracterização da relação com o trabalho. A alta prevalência de agravos do Capítulo XIX sugere precariedade das medidas de segurança no trabalho. Homens e mulheres apresentam diferentes perfis de acidentabilidade sem interferência na duração do benefício.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                February 2014
                : 48
                : 1
                : 186-190
                Affiliations
                [I ] Programa de Pós-Graduação em Saúde Pública. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
                [II ] Departamento de Saúde Ambiental. Faculdade de Saúde Pública. Universidade de São Paulo, SP, Brasil
                Author notes
                Correspondence: João Silvestre da Silva-Junior. Departamento de Saúde Ambiental. Faculdade de Saúde Pública. Av. Dr. Arnaldo, 715. 01255-000 São Paulo, SP, Brasil. E-mail: silvajunior.js@ 123456gmail.com
                Article
                10.1590/S0034-8910.2014048004802
                4206132
                24789650

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Brief Communication

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