Department of Public Health and Paediatrics, University of Turin, Turin, Italy.
Department of Public Health and Paediatrics, University of Turin, Turin, Italy.
Mult Scler Relat Disord. 2018 Aug;24:107-112. doi: 10.1016/j.msard.2018.06.016. Epub 2018 Jun 23.
Knowledge concerning the predictors of social security benefits and the proportion of Multiple Sclerosis (MS) patients receiving these benefits is very limited.
To estimate the likelihood of receiving social security benefits for Italian MS patients.
From September 2014 to November 2015, we interviewed MS outpatients from two Italian MS clinics to collect information regarding their personal data, clinical and working history, and access to social security benefits. We performed both univariate and multivariable analyses to evaluate the predictors for receiving social security benefits.
We interviewed 297 patients, with a mean age of 49.5 (± 10.7) years; 71.4% were females. About 73% of patients had a relapsing-remitting (RR) course and the median EDSS score was 2.5 (IQR 1.5-6). About 75% of MS patients received a full exemption from co-payments, while the proportions of people who enjoyed each of the other social security benefits were lower, ranging from 8.8% (car adaptation) to 32% (disable badge). At multivariable analysis, the probability of obtaining each of the benefits was significantly associated with the EDSS score: walking aids (OR 3.9), care allowance (OR 3.6), disabled badge (OR 2.4), exemption from co-payment (OR 1.6) and allowed off work permit (OR 1.7). Only the probability of obtaining an allowed off work permit was also influenced by comorbidities (OR 2.9) and a higher education (OR 2.2).
Except for full exemption from co-payments, the proportions of MS patients who enjoyed social security benefits seem to be limited in our study sample. The EDSS score is the strongest predictor of the probability of receiving all the benefits. Only a small proportion of patients received care allowance and working permits, probably because such benefits are only granted to people with a high level of disability. On the other hand, the low proportion of patients who enjoyed fiscal benefits for home and car adaptations could have been influenced by the way such benefits are granted in our country.
有关社会保障福利的预测因素以及获得这些福利的多发性硬化症 (MS) 患者比例的知识非常有限。
评估意大利 MS 患者获得社会保障福利的可能性。
我们于 2014 年 9 月至 2015 年 11 月期间采访了两家意大利 MS 诊所的门诊 MS 患者，收集有关个人数据、临床和工作史以及获得社会保障福利的信息。我们进行了单变量和多变量分析，以评估获得社会保障福利的预测因素。
我们采访了 297 名患者，平均年龄为 49.5（±10.7）岁；71.4%为女性。约 73%的患者有复发缓解型病程，EDSS 评分中位数为 2.5（IQR 1.5-6）。约 75%的 MS 患者免除了共付额，而享受其他社会保障福利的比例较低，从 8.8%（车辆改装）到 32%（残疾证）不等。多变量分析显示，获得每种福利的概率与 EDSS 评分显著相关：助行器（OR 3.9）、护理津贴（OR 3.6）、残疾证（OR 2.4）、共付额豁免（OR 1.6）和允许停薪留职（OR 1.7）。只有获得停薪留职许可的概率也受到合并症（OR 2.9）和高等教育（OR 2.2）的影响。
除了完全豁免共付额外，在我们的研究样本中，享受社会保障福利的 MS 患者比例似乎有限。EDSS 评分是获得所有福利的可能性的最强预测因素。只有一小部分患者获得护理津贴和工作许可，这可能是因为这些福利仅授予残疾程度较高的人。另一方面，享受家庭和车辆改装财政福利的患者比例较低可能受到我们国家授予此类福利方式的影响。
