English summaries
More significant role for occupational health care in long-term disability assessment
Julkaistu 17.08.2012 00.01
Background
The aim of this study was to assess the quality of medical statements on `B`-forms issued for disability pension or rehabilitation subsidy applications by occupational health care and specialised medical care facilities in the pension applications of two pension insurance providers (Keva and Varma Mutual Pension Insurance Company).
Methods
The study included `B`-form statements written for application for a first full disability pension or a cash rehabilitation benefit where the claimant was below the age of 60 and in a valid employment relationship at the time the statement was issued. The statements were grouped according to the place of issue: occupational health care or specialised medical care. The quality of the medical statements was assessed by collecting data using a data acquisition form. The statements were evaluated in each pension insurance company by two consultant physicians.
Results
The material included 109 medical statements. The average age of the claimants, of whom 63 were women (57.8%), was 51. The number of medical statements issued by occupational health care totalled 57 (52.2%). Only a third of the statements had been drawn up on a B2 form. Health status was missing from 19% of the statements issued by occupational health care and from 30% of the statements issued by specialised medical care. The results of diagnostic and functional capacity related examinations were described more clearly in statements issued by occupational health care (79%) than in statements issued by specialised health care (64%). Statements issued by specialised medical care more frequently assessed disease prognosis and proposed treatment plans, while statements issued by occupational health care more frequently described the patients` current work and their ability to cope. There were significant deficiencies in 20% of the statements, and in 18% of the cases it was necessary to request further clarification before making a decision on a benefit application.
Conclusions
There were no significant differences with respect to medical content between statements issued by occupational health care and those issued by specialised medical care, but information relating to the patients’ work and work capacity was described more clearly in statements issued by occupational health care than in statements issued by specialised medical care. The results of the study support the division of responsibility in long-term disability assessment under future legislation in which occupational health care would be given a more significant role in relation to other health care than is currently the case.
Jukka Kivekäs
Senior Lecturer, Physician-in-Chief
Mutual Pension Fund Varma
Timo Hannu, Tanja Rokkanen, Tapio Ropponen
Finnish Medical Journal 2012;67:2229–33
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