Programa de Pós-Graduação em Saúde Coletiva, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil.
Rev Saude Publica. 2012 Jun;46(3):425-34. doi: 10.1590/s0034-89102012005000025. Epub 2012 Apr 3.
To analyze factors associated with the duration of disability benefits due to work-related upper-limb musculoskeletal disorders.
Ambispective cohort study conducted with 563 insured workers from the General Social Security System who received temporary disability benefits due to work-related upper-limb musculoskeletal disorders in the city of Salvador, Northeastern Brazil, in 2008. The data came from an inquiry performed by the Regional Audit of the National Social Security Institute and from administrative records. Sociodemographic and work-related variables were analyzed, as well as characteristics of the health problem and aspects related to social security. Factors associated with time until the cessation of the benefit were identified through survival analysis techniques.
Low socioeconomic position (RR=1.29; 95% CI 1.02; 1.64), age below 39 years (RR=1.23; 95% CI 1.03; 1.47), income replacement by the National Social Security Institute < 100% (RR=1.24; 95% CI 1.04; 1.47) and high expectation of returning to work (RR=1.20; 95% CI 1.00; 1.44) are the categories related to higher rate of cessation of the benefit and with its shorter duration.
Factors that are not strictly medical, like socioeconomic position, age, expectation of returning to work and level of income replacement by the National Social Security Institute, seem to influence the benefit's duration. These hypotheses need to be tested with further confirmatory studies in order to improve the understanding of the process of determining incapacity for work.
分析与工作相关上肢肌肉骨骼障碍导致残疾津贴持续时间相关的因素。
这是一项前瞻性队列研究,共纳入了 2008 年巴西东北部萨尔瓦多市因工作相关上肢肌肉骨骼障碍接受临时残疾津贴的 563 名参保工人。数据来自国家社会保障协会区域审计的调查和行政记录。分析了社会人口学和与工作相关的变量,以及健康问题的特征和与社会保障相关的方面。通过生存分析技术确定与福利终止时间相关的因素。
低社会经济地位(RR=1.29;95%CI 1.02;1.64)、年龄低于 39 岁(RR=1.23;95%CI 1.03;1.47)、国家社会保障研究所收入替代率低于 100%(RR=1.24;95%CI 1.04;1.47)和高工作回归预期(RR=1.20;95%CI 1.00;1.44)与较高的福利终止率和较短的福利持续时间相关。
一些非严格意义上的医学因素,如社会经济地位、年龄、回归工作的预期和国家社会保障研究所的收入替代率,似乎会影响福利的持续时间。这些假设需要通过进一步的验证性研究来检验,以加深对工作能力丧失确定过程的理解。