Social Insurance Institution Research Articles

Analiza orzeczeń o niezdolności do samodzielnej egzystencji rozpatrywanych przez Zakład Ubezpieczeń Społecznych we Wrocławiu w 2016 roku u pacjentów z nowotworem złośliwym płuc w kontekście objęcia opieką paliatywną

Analiza orzeczeń o niezdolności do samodzielnej egzystencji rozpatrywanych przez Zakład Ubezpieczeń Społecznych we Wrocławiu w 2016 roku u pacjentów z nowotworem złośliwym płuc w kontekście objęcia opieką paliatywną

Impact of National Ten-Valent Pneumococcal Conjugate Vaccine Program on Reducing Antimicrobial Use and Tympanostomy Tube Placements in Finland.

Otitis media in young children is associated with major resource use including antimicrobial consumption and tympanostomy tube placements (TTPs). We evaluated the impact of 10-valent pneumococcal conjugate vaccine (PCV10) introduction into the Finnish National Vaccination Programme (NVP) against these outcomes in vaccine-eligible children. PCV10-NVP began September 2010 with a 2 + 1 schedule; uptake in 2012 was estimated at 92%. The relative and absolute reduction in the NVP-eligible target cohort was compared with a season and age-matched (3-54 months) cohort before NVP introduction. Outpatient antimicrobial purchase data were collected from the Social Insurance Institution register. Data on purchases of antimicrobials recommended for treatment of acute otitis media by the Finnish Current Care Guidelines (amoxicillin with/without enzyme inhibitor, cefuroxime, cefaclor, clarithromycin, azithromycin) were collected, but full data on penicillin and sulfadiazine/trimethoprim were not available. Data on all TTP procedures were obtained from national hospital discharge register and Social Insurance Institution benefits register. Generalized Cox regression was used in the analysis. The incidence rates of antimicrobial purchases in the reference and target cohorts were 1.09 and 0.89 per person-year, respectively. The relative rate reduction was 17.5% (95% confidence interval: 17.0-18.1) and the absolute rate reduction 0.20 per person-year. The rates of TTP in the reference and target cohorts were 5.41/100 and 4.56/100 person-years, respectively. The relative rate reduction was 14.8% (95% confidence interval: 13.1-16.5) and the absolute rate reduction 0.86/100 person-years. Use of antimicrobials and TTPs reduced after PCV10 was introduced into a routine vaccination program. This suggests considerable savings in health care resource use.

Platforma usług elektronicznych Zakładu Ubezpieczeń Społecznych (PUE ZUS) jako nowoczesne narzędzie komunikacji administracji państwowej z obywatelami - analiza szans i zagrożeń

Launched in 2012, The Polish Social Insurance Institution Electronic Services Platform (PUE ZUS) has been a key innovation in functioning of the Polish social security system. The citizens have gained the possibility to check data entered into their accounts in The Polish Social Insurance Institution (ZUS). The main goal of this article is analysis of the relation between insured persons and the data entered into their individual accounts in The Polish Social Insurance Institution in the context of opportunities and threats for the functioning of Polish social security system. Author of the article has given much attention to the role of PUE ZUS in shaping social security of the citizens, especially in the face of the thorough reform of the Polish social security system in 1999.

FAMILY 500 PLUS PROGRAMS AND FLAT PLUS WITH KEY INSTRUMENTS FOR PRIVATE SOCIAL POLICY IN POLAND

In Poland, for many years, relatively large incomes have reached large families. Similar relationships are shaped in the area of housing and household equipment in durable goods. The purpose of the Family 500 Plus program launched in April 2016 is to significantly reduce the scale of this socially and economically disadvantageous relationship, ie the current lowest profitability in large families. Apart from current, mainly profitable goals, improvement of the financial situation of families, this program also has an important long-term goal. The long-term strategic goal of the Family 500 Plus program is to change the demographic structure of society in Poland in the direction of increasing fertility, ie rejuvenating the society. Considering the public financial system of the state, this is a strategic goal of socio-economic policy to reduce the demographic scale of the aging process, ie limiting the potential for announcement in the next several decades of insolvency of the participatory pension system operated by the Social Insurance Institution. The second key program of social family policy in Poland launched in December 2016 is the Mieszkanie Plus program. This program, through the improvement of the housing situation, should fulfill important functions of housing policy in the scope of reducing the social stratification of families in Poland. The main objective of the Mieszkanie Plus program is to significantly increase the availability of flats, especially low-cost rental apartments, with the option of purchasing property after 20-30 years of use. In addition, both of the socio-economic policy programs mentioned above should also have a positive impact on the domestic economy, thus contributing to the reduction of income social stratification and to the activation of economic growth.

The association between asthma and type 1 diabetes: a paediatric case-cohort study in Finland, years 1981-2009.

The association between asthma and type 1 diabetes, two chronic, immune-mediated diseases, has been of longstanding interest, but the evidence is still conflicting. We examined this association in a large, nationwide case-cohort study among Finnish children, using a novel statistical approach. Among the initial cohort of all children born between 1 January 1981 and 31 December 2008, those who were diagnosed with asthma (n = 81 473) or type 1 diabetes (n = 9541) up to age 16 years by the end of 2009 were identified from the Central Drug Register maintained by the Social Insurance Institution of Finland. A 10% random sample from each initial birth year cohort was selected as a reference cohort (n = 171 138). The association between asthma and type 1 diabetes was studied using a multistate modelling approach to estimate transition rates between healthy and disease states since birth. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to represent the change in the transition rate between the disease states. After adjusting for sex and birth decade, previous diagnosis of asthma increased the risk of subsequent type 1 diabetes by 41% (95% CI: 1.28, 1.54), whereas previous diagnosis of type 1 diabetes decreased the risk of subsequent asthma by 18% (95% CI: 0.69, 0.98). The findings of the present study imply that the association between the diseases is more complex than previously thought, and its direction depends on the sequential appearance of the diseases.

NON-AGRICULTURAL ECONOMIC ACTIVITY IN THE SYSTEMS OF PUBLIC SOCIAL INSURANCE AND SOCIAL INSURANCE FOR FARMERS

The aim of the study was to compare conducting economic activity by people covered by social insurance and by social insurance for farmers in the years 2013-2017. The former included old-age pension insurance, disability and survivors’ insurance, sickness insurance, accident and health insurance as well as contributions for the Labour Fund. Social insurance for farmers was defined based on old-age and disability insurance, sickness insurance, accident insurance and maternity insurance. Monthly contributions for social insurance for persons conducting non-agricultural economic activity were three times higher in the public system of social insurance (ZUS, or National Social Insurance Institution). However, when health insurance and Labuor Fund contributions were included, they were five times higher than agricultural social insurance (KRUS, or Agricultural Social Insurance Fund). The share of social and health insurance in the income of persons commencing economic activity was more than twice higher than in the income of persons insured by KRUS.

Identyfikacja tendencji i uwarunkowań związanych z poziomem płac w Polsce, na podstawie przeciętnych wynagrodzeń realnych wypłacanych w latach 2004 2014

Aim: The aim of this article is to identify trends and determinants related to the development of thelevel of wages in Poland. The issue is important as the level of payment received by employees inreturn for their work is reflects the state of economic development.Design / Research methods: In the article data of average wages in Poland available in the SocialInsurance Institution as well as the Central Statistical Office are presented and analyzed.Conclusions / findings: During the researched period (2004-2014), average real wage hassystematically increased. This is a positive phenomenon, both from the point of view of an individualworker as well as the whole economy, as it indicates continued economic development of in Poland.

Wybrane problemy przedsądowego postępowania w zakresie ubezpieczeń społecznych

SELECTED PROBLEMS OF PREJUDICIAL PROCEEDINGS IN THE FIELD OF SOCIAL INSURANCEThe article describes the procedural aspect of the Social Insurance Institution which, as an institution performing the tasks of the state, conducts proceedings which assess the rights and obli­gations of customers. Conducted proceeding is terminated by adecision. Generally it is adeclara­tory decision, which means that it doesn’t create aright to benefits, only confirms them. The Social Insurance Institution issues aconstitutive decisions, giving law, so-called decisions discretion.The proceeding in the field of social insurance must take into account the principle of respect for the public finances. Balancing the interests of the citizen and the national interest requires know­ledge of law, ability to interpret and use it, but also well-educated, competent employees, precise internal procedures, efficient flow of information and modern tools.

Zwrot świadczeń nienależnych w prawie ubezpieczeń społecznych — wybrane zagadnienia

RECOVERY OF UNDUE BENEFITS IN THE SOCIAL INSURANCE SCHEME — SELECTED ISSUESThe article refers to the selected issues of the recovery of undue benefits in the social insurance scheme. Initially, the subject matter of the analysis is the recent modification of the art. 84 of the Act of 13 October 1998 on the social insurance system. It is argued in the article that there are not per­suasive arguments why the recent change — introducing the limit for handing down adecision for the Polish Social Insurance Institution art. 84 [7a] of the Act on the social insurance system — does not relate to the contribution payer or the other persons enumerated in the art. 84 6 of the Act on the social insurance system. Furthermore, the paper analyses the notion of the undue benefit in the social insurance scheme and the issues of the instruction. In the article there are emphasized some questions referring to the explanatory proceedings conducted by the Polish Social Insurance Insti­tution ZUS and the issues of the relations between the art. 84 1 and 6 of the Act on the social insurance system. In the conclusion the article analyses the relations between the art. 84 of the Act on the social insurance system and the special regulations, i.e. art. 138 of the Act of 17 December 1998 on pensions from the Social Insurance Fund and art. 66 of the Act of 25 June 1999 on cash social insurance benefits in respect of sickness and maternity.

Cost Effectiveness Of Contour Curved Cutter Stapler In Low Anterior Resection In Turkey

Contour Curved Cutter Stapler is a multifire, single patient use device with a curved head that cuts and staples. The device is used for transection, resection, and/or creation of anastomoses. The instrument has application in multiple open or minimally invasive general (gastrointestinal and skeletal muscle), gynecologic, urologic and thoracic surgical procedures. The objective of this study is to assess the cost effectiveness of Contour in low anterior resection (LAR) in Turkey. A simple decision making model was used in assessing the cost effectiveness of Contour. Use of our Contour was compared with non-use. The ICER was calculated as additional cost per avoided complication. The analyses were made from the perspective of the Social Insurance Institution. Cost data regarding the type and frequency of resources used before, during and after LAR and in treatment of complications with and without Contour were obtained from expert views. Complications were listed as recurrence, colostomy, anastomose leakage and wound infection. Epidemiologic data and complication rates were obtained from literature and expert views. Total cost per patient of LAR with Contour stapler was found as 2,894 TRY. Total number of LAR patients for 2017 was estimated as 13,694. Of these patients 8,379 had complications if Contour is not used whereas 1,676 patients had complications when Contour is used. The total annual costs of operations including cost of complications were 54,569,305 TRY and 97,775,068 TRY for LAR with Contour and LAR without Contour respectively. With these results, LAR with Contour dominated LAR without Contour. These results showed that Contour is a cost-effective option LAR in Turkey

Occupational class differences in diagnostic-specific sickness absence: a register-based study in the Finnish population, 2005\u20132014

BackgroundMusculoskeletal diseases and mental disorders are major causes of long-term sickness absence in Western countries. Although sickness absence is generally more common in lower occupational classes, little is known about class differences in diagnostic-specific absence over time. Focusing on Finland during 2005–2014, we therefore set out to examine the magnitude of and changes in absolute and relative occupational class differences in long-term sickness absence due to major diagnostic causes.MethodsA 70-per-cent random sample of Finns aged 25–64 linked to register data on medically certified sickness absence (of over 10 working days) in 2005–2014 was retrieved from the Social Insurance Institution of Finland. Information on occupational class was obtained from Statistics Finland and linked to the data. The study focused on female (n = 658,148–694,142) and male (n = 604,715–642,922) upper and lower non-manual employees and manual workers. The age-standardised prevalence, the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were calculated for each study year to facilitate examination of the class differences.ResultsThe prevalence of each diagnostic cause of sickness absence declined during the study period, the most common causes being musculoskeletal diseases, mental disorders and injuries. The prevalence of other causes under scrutiny was less than 1 % annually. By far the largest absolute and relative differences were in musculoskeletal diseases among both women and men. Moreover, the absolute differences in both genders (p < 0.0001) and the relative differences in men (p < 0.0001) narrowed over time as the prevalence declined most among manual workers. Both genders showed modest and stable occupational class differences in mental disorders. In the case of injuries, no major changes occurred in absolute differences but relative differences narrowed over time in men (p < 0.0001) due to a strong decline in prevalence among manual workers. Class differences in the other studied diagnostic causes under scrutiny appeared negligible.ConclusionsBy far the largest occupational class differences in long-term sickness absence concerned musculoskeletal diseases, followed by injuries. The results highlight potential targets for preventive measures aimed at reducing sickness absence and narrowing class differences in the future.

Changes in psychosocial and physical working conditions and psychotropic medication in ageing public sector employees: a record-linkage follow-up study

ObjectivesTo investigate whether changes in psychosocial and physical working conditions are associated with subsequent psychotropic medication in ageing employees.MethodsData were from the Helsinki Health Study, a cohort study of Finnish...

DEMOGRAPHIC, SOCIAL AND ECONOMIC DETERMINANTS OF THE PENSION REFORM PAYMENT PLAN OF THE PENSION SYSTEM BASED ON TRANSFER OF CAPITAL FROM OPF FUNDS TO IPA

The article describes the demographic, social and economic determinants of the capital reform plan of the pillar of the pension system based on the transfer of capital from Open Pension Funds to the Individual Pension Accounts system. The purpose of the planned pension reform is to improve the efficiency of the capital pillar of the pension system. Reform should also counteract the negative impact of demographic change, i.e. the aging process, on the public finances of the participatory pension system managed by the Social Insurance Institution. From mid-2016, the Ministry of Development had present the "Capital Construction Program", that is an important pillar of economic policy developed in Poland in 2017, at press conferences organized by the Warsaw Stock Exchange. The main assumptions of this economic policy are laid down in the so plan for responsible development.

THE IMPORTANCE OF THE 500 PLUS FAMILY PROGRAM AS AN IMPACT FACTOR OF FAMILY POLICY IN FAMILY INVESTMENT IN POLAND

n Poland since the beginning of the systemic transformation of the 1990s, the relatively low incomes of many families have been relatively low. Similar relationships exist in terms of material, housing and financial savings. Launched in April 2016, the 500 Plus Program contributes to a significant reduction in the scale of this socially and economically disadvantageous relationship, i.e. the current lowest profitability in families with many children. Moreover, the profitability and generating of surplus financial households in Poland are on average several times lower than in the financial situation of families in Western European countries. The strategic goal in this way of developing family policy is to increase the fertility in Poland in the coming years, which is to counteract the unfavorable demographic trends of the aging population. It is now assumed that the 500 Plus Program should work positively on the strategic socio-economic objective of reducing the demographic aging of the population, i.e. limiting the potential for publication in the perspective of the next few years of insolvency conducted by the Social Insurance Institution of the participatory pension system. The 500 Plus program is an important instrument for a comprehensive family investment policy in Poland.

Assessing the effects of price regulation and freedom of choice on quality: evidence from the physiotherapy market

In health care, many aspects of the delivery of services are subject to regulation. Often the purpose of the regulated health care system is to encourage providers to keep costs down without skimping on quality. The purpose of this paper is to analyse the effect of price regulation and free choice on quality in physiotherapy organised by the Social Insurance Institution of Finland for the disabled individuals.We use the difference-in-differences method in our effort to isolate the effect of the regulation and for this task we have defined the regulated and non-regulated firms and their quality before and after the regulation. The variables needed in the econometric modelling were collected from several registers as well as by carrying out questionnaires on the firms.We show that price regulation decreased quality in physiotherapy statistically significantly and the mechanism was unable to incentivise firms to invest in quality. Most likely, our results are caused by cost reduction associated with price regulation. It seems that cost reduction was carried out through quality reductions in physiotherapy instead of increasing productivity. The result is sensible because comparable quality information is not published to support patient choice in this sector.

Co-morbidity and clinically significant interactions between antiepileptic drugs and other drugs in elderly patients with newly diagnosed epilepsy.

A study was conducted to investigate the frequency of potential pharmacokinetic drug-to-drug interactions in elderly patients with newly diagnosed epilepsy. We also investigated co-morbid conditions associated with epilepsy. From the register of Kuopio University Hospital (KUH) we identified community-dwelling patients aged 65 or above with newly diagnosed epilepsy and in whom use of the first individual antiepileptic drug (AED) began in 2000-2013 (n=529). Furthermore, register data of the Social Insurance Institution of Finland were used for assessing potential interactions in a nationwide cohort of elderly subjects with newly diagnosed epilepsy. We extracted all patients aged 65 or above who had received special reimbursement for the cost of AEDs prescribed on account of epilepsy in 2012 where their first AED was recorded in 2011-2012 as monotherapy (n=1081). Clinically relevant drug interactions (of class C or D) at the time of starting of the first AED, as assessed via the SFINX-PHARAO database, were analysed. Hypertension (67%), dyslipidemia (45%), and ischaemic stroke (32%) were the most common co-morbid conditions in the hospital cohort of patients. In these patients, excessive polypharmacy (more than 10 concomitant drugs) was identified in 27% of cases. Of the patients started on carbamazepine, 52 subjects (32%) had one class-C or class-D drug interaction and 51 (31%) had two or more C- or D-class interactions. Only 2% of the subjects started on valproate exhibited a class-C interaction. None of the subjects using oxcarbazepine displayed class-C or class-D interactions. Patients with 3-5 (OR 4.22; p=0.05) or over six (OR 8.86; p=0.003) other drugs were more likely to have C- or D-class interaction. The most common drugs with potential interactions with carbamazepine were dihydropyridine calcium-blockers, statins, warfarin, and psychotropic drugs. Elderly patients with newly diagnosed epilepsy are at high risk of clinically relevant pharmacokinetic interactions with other drugs, especially if exposed to carbamazepine, but these interactions can be controlled via rational drug choices and with prediction of the possible drug-to-drug interactions. Patients on dihydropyridine calcium-channel blockers, statins, warfarin, and risperidone face the highest risk of interactions.

Cranioplasty as the return-to-work factor - 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz.

The number of craniectomies and the consequent reconstructive procedures has grown during the past decades. Cranial defects and methods of their repair could have some influence on work capability of the patients and their employability. The authors analyzed a group of 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz, Poland, in the course of the katamnestic period longer than 6 months after reconstructive operation, and observed them between February 2008 and February 2015. Their work capability and employment were compared, all the patients were interviewed concerning the reasons for not working according to the Social Insurance Institution predication procedure. Before the cranioplasty, all the patients were capable of working without limitations according to biological criteria and 89 of them were employed. Twenty-three not working people consisted of 6 pupils, 7 retired and 10 not working for other reasons. During the period between the craniectomy and the cranioplasty, 88 patients were capable of working and only 2 were employed. After the reconstruction, 93 were capable of working without limitations and 16 - with limitations. Forty-seven were employed during the period of the follow-up, the rest of patients consisted of 2 pupils, 13 retired and 50 not working for various reasons. Cranioplasty is a very important factor contributing to return to work. This outcome may be seen as having a great social value and be added to the functions of cranial repair as protective, esthetic and normalizing the intracranial pressure previously described in the literature. Int J Occup Med Environ Health 2017;30(5):803-809.

Detailed Analysis of The Laffer Effect at Turkish Social Security Administration Premium Revenue

This study is an attempt to analyse and deep the social security premium rate/load as a factor that influences the premium revenues for the Turkish Social Security Administration by using the Laffer curve logic and to identify relation and the premium load that maximizes premium revenues and assessing the revenue increase for the Administration. Turkish Social Security system separates the employees in three main groups: Indıvıduals working on service contract who are subject to SSK (Social Insurance Administration), Individuals working on their own names and accounts who are subject to Bag-Kur (Craftsmen And Artisans And Other Self-Employed Social Insurance Institution) and public employees or civil servants who are subject to ES (Retirement Fund General Directorate) before the social security reform. The previous studies; “Model Proposal for Investigating and Increasing the Social Security Administration’s Premium Collection Revenue” analysed the relationship between the premium revenue and premium rate/load for all the employees, make a total analyse for premium rate and revenue and “The Laffer Effect at Turkish Social Security Administration’s Premium Revenue” analysed the most crowded group of the Turkish Social Security system SSK.In this study it will be focused on Bag-Kur and ES premium revenue. The monthly data for the period between January 2009 and December 2012 were used in this study.&#x0D; Keywords: Premium Rate; Premium Revenue; Earnings Based On Premium; The Laffer Curve&#x0D;

Flourishing: Factors associated with positive mental health among young adults with neuropsychiatric disorders

Young people with Asperger's syndrome and/or ADHD face major challenges in their lives affecting their quality of life and general well-being.The aim of this study was to investigate factors that associate with positive mental health (flourishing) among young adults with neuropsychiatric disorders.The sample consisted of 188 young adults with diagnosis of Asperger's syndrome (AS) (F84.5) and/or ADHD/ADD (F90). They participated in the one-year “My Way” rehabilitation programme organized and funded by the social insurance institution of Finland. Baseline questionnaires included measures on positive mental health (SWEMWBS), provisions of social relationships (SPS), social competence (MASC) and questions about functional capacity and leisure time activities. Information on diagnosis was received from doctors’ statements.Of the study participants, 35% had a comorbid mood, anxiety or stress-related disorder (F30-F40). Among those, 14% had low, 79% moderate and 7% high positive mental health (flourishing). Higher rate of physical activity was associated with flourishing. Furthermore, flourishing was associated with high level of provisions of social relationships, social competence as well as good general functional capacity. No association was found with engagement in employment or education, or having the diagnosis of AS, ADHD/ADD or a comorbid psychiatric disorder (F30–F40).People with psychiatric disorders experience high positive mental health, too. Social relations, social competence and general functional capacity play an important role in mental well-being of young adults with neuropsychiatric disorders. Supporting them may help in reaching also other goals set for the rehabilitation, such as capacity to work or study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Wykorzystanie eksploracji danych w planowaniu kontroli płatników składek przez Zakład Ubezpieczeń Społecznych

This paper presents issues associated with the possible application of data mining in the planning of inspections in Polish Social Insurance Institution. Discussed problems are focused on the characteristics of currently existing methods of planning and inspection subjects’ selection. Furthermore, assumptions and the description of data mining mechanism of action, within that certain field, are also introduced. To most important conclusion is the statement, that there is a possibility of data mining application within the scope of model prediction, which allows for ascertaining the risk of occurrence of potential irregularities. Utilization of information about such potential risks could give benefits, mainly to the inspector, due to the plausibility of more precisely planned inspection.