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巴西因慢性静脉疾病导致临时工作残疾的时间趋势和社会保障负担。

Time trends and social security burden of temporary work disability due to chronic venous disease in Brazil.

机构信息

Federal University of Sergipe Hospital , Rua Cláudio Batista, s/n, Bairro Cidade Nova, Aracaju- SE, CEP: 49060-108, Brazil.

National Institute of Social Security, Aracaju, Sergipe, Brasil.

出版信息

BMC Public Health. 2020 Apr 10;20(1):477. doi: 10.1186/s12889-020-08563-2.

Abstract

BACKGROUND

Chronic venous disease (CVD) and disability are worldwide problems and have significant socioeconomic implications. This study aims to analyze the time trends and social security burden of temporary work disability due to CVD in Brazil.

METHODS

An ecological time series study using the Brazilian Social Security System database was performed from 2005 to 2014. Data from all benefits granted to workers with temporary disability due to CVD were analyzed. The cases were identified using diagnosis codes I83-I83.9 of the International Classification of Diseases 10th Revision (ICD-10). The time trend analyses were performed by the Joinpoint Regression Model, with sex, age, regions, income, and category of affiliation as variables. Crude and age-standardized rates were calculated.

RESULTS

A total of 429,438 benefits were granted for temporary work disability due to CVD from 2005 to 2014, with a growing trend and an age-standardized annual percent change (APC) of 3.4 (95% CI: 2.6-4.2) (p < 0.05). Social security expense increased 3.5-fold, and the number of days in benefit doubled from 2005 to 2014. In total, 27,017,818 working days were lost. The average duration of benefits was 55.3 days. The majority of workers were women (68.2%) (p < 0.001), between 30 and 59 years old, employed, had a monthly income ≤2 minimum wages (MW) (83.2%), and lived in the regions southeast (53.6%) and south (29.3%). Significantly higher APCs were observed for women than for men (APC: 4.9, 95% CI: 4.0-5.7 versus APC: 1.2, 95% CI: 0.1-2.4). All regions in Brazil had a significant growing trend, except in the north. No significant growth was observed in the age group of 60-69 years. A decreasing trend was observed in workers with monthly incomes above 2 MW (p < 0.05).

CONCLUSIONS

Temporary work disability due to CVD and social security burden showed increasing trends with millions of working days lost, particularly among women and low-income workers. Preventing disability is challenging, and public policies are needed to reduce the social and economic impact of disability. Therefore, measures for promoting health at the workplace should be encouraged.

摘要

背景

慢性静脉疾病(CVD)和残疾是全球性问题,对社会经济具有重大影响。本研究旨在分析巴西因 CVD 导致的临时工作残疾的时间趋势和社会保障负担。

方法

本研究使用巴西社会保障系统数据库进行了一项生态学时间序列研究,时间范围为 2005 年至 2014 年。分析了所有因 CVD 导致的临时工作残疾工人的福利数据。使用国际疾病分类第十版(ICD-10)的 I83-I83.9 诊断代码识别病例。通过 Joinpoint 回归模型进行时间趋势分析,将性别、年龄、地区、收入和隶属类别作为变量。计算了粗率和年龄标准化率。

结果

2005 年至 2014 年期间,共有 429438 项因 CVD 导致的临时工作残疾福利,呈上升趋势,年龄标准化年平均百分比变化(APC)为 3.4(95%CI:2.6-4.2)(p<0.05)。社会保障支出增加了 3.5 倍,福利天数增加了一倍。总共有 27017818 个工作日缺勤。福利的平均持续时间为 55.3 天。大多数工人为女性(68.2%)(p<0.001),年龄在 30-59 岁之间,受雇,月收入≤2 最低工资(MW)(83.2%),居住在东南部(53.6%)和南部(29.3%)地区。女性的 APC 明显高于男性(APC:4.9,95%CI:4.0-5.7 与 APC:1.2,95%CI:0.1-2.4)。巴西所有地区均呈显著上升趋势,北部除外。60-69 岁年龄组未见明显增长趋势。月收入超过 2MW 的工人呈下降趋势(p<0.05)。

结论

因 CVD 导致的临时工作残疾和社会保障负担呈上升趋势,导致数百万个工作日缺勤,尤其是女性和低收入工人。预防残疾具有挑战性,需要制定公共政策来减轻残疾的社会和经济影响。因此,应鼓励采取促进工作场所健康的措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df44/7147047/31735df4dd04/12889_2020_8563_Fig1_HTML.jpg

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