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At least 433 records · Page 24Linked to original sources
PubMed1982

[The new Spinal Cord Injuries Centre of the Hamburg Industrial Injuries Insurance Institutes Accident Hospital--report on its 1st year].

The former Spinal Cord Injuries Department within the Hamburg Accident Hospital of the Industrial Injuries Insurance Institutes has been expanded from 33 to 100 beds. 60 beds started operation on Febr. 1, 1981, another 20 on Aug. 1, 1981 and the remaining 20 beds on Jan. 1, 1982. The present report is based on admissions during the first twelve months of the Centre's operation, i.e. 136 recent cases and 98 re-admissions, 92% of which had come from Northern Germany. 35% of the recent cases had been admitted during the first 48 hours post-onset. 39% of the patients were tetraplegics, 57% had complete paralysis, 13% non-traumatic affections. 60% of the patients had associated injuries. 60% were covered by statutory sickness insurance. The average length of stay was 113 days for tetraplegic, and 112 days for paraplegic patients. In 60% the extent of paralysis remained unchanged. Of 10 deaths, three were due to pulmonary embolism. Decubitus ulcers had been the indication for re-admission in 36%, of whom only 20% were tetraplegics. Average stay for decubitus ulcers was three times as long as in other re-admission causes. The services rendered by the various professional departments as well as by medical consultants are reported in tabular form. The expansion responded to an urgent need, and has, among others, contributed to easing many avoidable social problems (such as long distances from home).

Adolescent↗
PubMed2006

[Retrospective analysis of falls in an inpatient rehabilitation centre for rheumatic and orthopaedic diseases].

AIM: To analyse the frequency and circumstances of falls in an inpatient rehabilitation centre. METHODS: In a survey all falls reported to the Austrian accident insurance carrier were analysed and external circumstances of falls were evaluated. The survey covers a period of 64 months (Jan 2000 to April 2005): 10 820 inpatients (234 502 patient days); mean age 52.8 years; 1,252 patients aged >/= 70 years; 47 % male, 53 % female. RESULTS: Of 223 accidents registered, 140 (62.8 %) were falls. Of these, 17 patients had to be referred to a surgical unit for further treatment. In total, 1.29 % of all patients fell during their stay (with report to the accident insurance carrier), 0.16 % suffered major injuries from falls (with referral to surgical unit). Females fell more frequently than males. 39 % of the falls were associated with physical therapy. Most falls occurred in daytime. The location in the centre or the day of week showed no major influence on the frequency of falls. Falls occurred slightly more often in the first part of the three-week inpatient stay. CONCLUSION: The high total number of falls shows that falls are important in an inpatient rehabilitation centre for rheumatic and orthopaedic diseases. The analysis did not reveal any special location inside the rehabilitation centre with an increased risk of falls calling for urgent interventions. The active and activating physical therapies do not seem to increase the number of falls significantly.

Accidental Falls↗
PubMed2005

Work-related accidents and occupational diseases in veterinarians and their staff.

OBJECTIVES: We assessed the occupational hazards in veterinary practice by analysing accident insurance data in order to stimulate strategies to prevent occupational accidents and diseases in veterinarians and their staff. METHODS: Approximately 10,000 veterinary practices comprising about 27,500 veterinarians and their staff are covered by the Institution of Statutory Accident Insurance of the Health and Welfare Service (BGW). Each year about 2,000 accident and occupational disease claims are filed by these veterinarians and their staff. The claims for the 5-year period from 1998 to 2002 are analysed in this paper. RESULTS: For 2002, the incidence rate for accidents in the workplace was 105.4 per 1,000 full-time workers, a rate 2.9-times higher than for general practitioners of human medicine. When only severe accidents resulting in a loss of work time of more than 3 days were analysed, the relative risk increased to 9.2. Approximately 66% of the reported accidents are due to scratches, bites, or kicks from animals. Claims of occupational disease are filed 2.7-times more often by veterinarians and their staff than by general practitioners and their staff. The occupational diseases filed most often concern the skin (39%), followed by allergic respiratory diseases (30.5%), and infectious diseases (19.1%). CONCLUSIONS: Prevention strategies for veterinarians should focus on accidents caused by animals. The prevention of occupational diseases should focus on skin diseases, respiratory disease, and infections.

Accidents↗
PubMed2005

[Ratio of confirmed versus suspected occupational diseases as a parameter of quality].

PURPOSE: To evaluate the notifications of suspected causes of occupational diseases (NSC) under quality assurance aspects. METHODS: We retrospectively analysed the NSC assessed by the institutions for statutory accident insurance and prevention (Berufsgenossenschaft) between 1998 and 2002. RESULTS: Physicians were most frequently represented among the 357,050 notifications (60.2 %). The number of notifications dropped continually between 1998 and 2002. The number and quality of the notifications (NSC) depend on the knowledge of the occupational diseases as well as on the knowledge of the insured persons and on their respective occupational histories. The NSC are issued via the statutory social insurance bodies who are in contact with the patients, and the NSC also depend on the present scientific knowledge of the types of relevant diseases. Usually, the physicians were most frequently the notifiers of occupational diseases, with one exception, namely, incapacitating diseases due to damage to vertebral discs of the lumbar spine caused by many years of lifting of carrying heavy loads or of many years of work in an extremely bent position, in which cases the statutory insurance bodies themselves issued the notifications. Altogether 123,262 notifications were confirmed. The average quota of confirmations was > 40 % with physicians issuing the notifications, > 30 % with statutory pension insurance bodies and only approx. 12 % with notifying statutory sickness insurance bodies. The lowest quota of confirmations - namely, only 3 % - concerned the incapacitating vertebral disc disease of the lumbar spine mentioned above. Non-confirmed notifications of suspected occupational diseases involved an estimated cost of at least 58 million Euro. DISCUSSION: On-target improvement of the quality of notification of suspected occupational diseases is possible by exploring several avenues, including on-target assessment of evaluation criteria reporting by the statutory accident insurance bodies concerned and by regular advice rendered to the statutory social insurance bodies by occupational therapists.

Accidents, Occupational↗
PubMed2002

[100 years with certificates: Danish Society of Insurance Medicine 1902-2002].

Danish Society of Insurance Medicine was formed in 1902 as an association between the Danish Society of Accident Insurance and the Danish Society of Life Insurance Medicine, both founded a year before. The purpose of the society is to apply and to further the scientific basis of insurance medicine. The meetings also play a role as a forum for discussions. The members of the society are all working part-time in an insurance company in Denmark (in contrast to many other countries where it is a full-time job). The members are mainly specialists in medicine and surgery. During the first half life of the society nearly all members were high-qualified doctors, i.e. professors and consultants at a university hospital in Copenhagen usually with a doctoral degree. These prominent doctors had a significant influence on insurance medicine in Denmark. The managing directors of the Insurance Companies were invited to the meetings. Many scientific works and textbooks were written on the subject. The society arranges two meetings yearly - one concerning with life insurance and one with accident-insurance medicine. Previously, the question put to the medical adviser was always "Which impairments can still be insured?", but today the question is the opposite "Which impairments are not insurable?" The members have increased to currently 112, still only men, but today the members are younger, comprise fewer professors and fewer with a doctoral degree. During the last 6 years, all interested members in the insurance companies have been invited to the meetings, providing a broader input for the discussions. The topic of the meeting is of current interest: new laws or a new treatment of a disease (medication, surgery) which has been introduced. One to three speakers open the meeting, followed by a discussion. The meetings are always concluded with a light meal and a glass of wine, in earlier days also with cigars and Danish schnaps. 190 meetings have been held during the last 100 years. Often the speakers are members of the society. In the future the Danish Society of Insurance Medicine will face new challenges as regards to the communication of knowledge about new diseases and new treatments in the light of with biostatistics and new insurance products.

Denmark↗
PubMed2000

[Insufficient legal rights of traffic accident victims. Insurance companies should force more active compensation claims].

According to law, persons injured in road traffic accidents are entitled to compensation. In almost 92% of cases, victims accept a modified solution suggested by the insurance company involved. If an agreement cannot be reached, or the disability is 10% or more, the case is referred to The Road Traffic Injuries Commission (TSN). Insurance companies often claim that the lengthy wait for a final ruling--up to four years or more--is due to the lack of a doctor's certificate of disability.

Accidents, Traffic↗
PubMed1999

Improving prognosis of type 1 diabetes. Mortality, accidents, and impact on insurance.

OBJECTIVE: Individuals with type 1 diabetes applying for insurance (life, health, accident, etc.) may either see their application being declined by the insurance company or find their premiums being substantially higher than the standard premium. During the last 40-50 years, the prognosis of patients with type 1 diabetes has improved dramatically, partly as a consequence of improved metabolic regulation and partly due to introduction of better treatment for late diabetic complications. The aim of the present study was to determine whether the increased premiums paid by diabetic patients for life insurance and accident insurance reflect the true risk of a diabetic individual. RESEARCH DESIGN AND METHODS: Mortality: 3,000 type 1 diabetic patients were followed for 12-51 years. The impact of age, sex, year of diagnosis, and development of nephropathy on excess mortality was analyzed. Accidents: A cohort of nearly 7,000 members of the Danish Diabetes Association participating in group accident insurance was followed for 3 years. The risk and outcome of accidents in the diabetic group was compared with similar risks in a nondiabetic group. RESULTS: Mortality: Over a 40-year period, the median life expectancy of type 1 diabetic patients increased by more than 15 years. The decrease was predominantly explained by a decreasing incidence of nephropathy, so that a simple model for estimating insurance premiums (including age of diagnosis, sex, and presence or absence of diabetic nephropathy) could be established. Accident insurance: Individuals with type 1 diabetes experienced a risk of accidents that was not in excess of that found in two control groups, and the outcome (degree of disability) after the accidents did not differ between the diabetic and the nondiabetic group. CONCLUSIONS: Type 1 diabetic patients still have a mortality in excess of nondiabetic individuals. Life insurance premiums should, however, always reflect the changing prognosis of type 1 diabetes and thus, continuous monitoring and revisions are needed. For accident insurance, we found no increased risk of accidents; thus, diabetic individuals should be offered accident insurance on normal terms.

Cohort Studies↗
PubMed1981

[Executive agencies for occupational law and their contribution to work safety].

The legislation and its execution in the field of work safety is still characterized today by a dualism between the sickness and accident insurance laws (which are executed primarily by the Swiss National Accident Insurance Fund) and the employment laws (which are administered by the cantonal Work Inspectorates, under the supervision of the Federal Office for Industry, Trade and Work). The administrative duties in this area are not limited to accident prevention in the place of work, but extend to the review and the provision of permits for planned future industrial enterprises and any subdivisions thereof.

Accidents, Occupational↗
PubMed1989

[Employee protection and occupational medicine in Switzerland. Legal and organizational aspects].

The regulations aimed at protecting the health of workers are essentially contained in both the Labour Law (general hygiene, duration of work and rest periods, special protection of women and minors) and in the Law Governing Accident Insurance (prevention of accidents and professional illnesses). The employer is obliged to take all the necessary measures for the protection of his employees and to ensure the collaboration of the latter to this end. The National Insurance together with the federal and cantonal Labour Law enforcement agencies share the task of supervising the application of legal health protection. In particular, the National Insurance and the Confederation have a medical service at their disposal. In order to comply with requirements, large firms have their own health and safety service, some with an industrial physician. An ordinance which will oblige high risk firms or firms above a certain size to have resident industrial physicians as well as other labour safety specialists is at present being discussed. One of the aims of the proposed revision of the Labour Law is an improvement in the medical supervision of workers exercising their profession at night.

Accidents, Occupational↗
PubMed1992

[Clinical aspects, pathophysiology, therapy and expert evaluation of splenectomy].

Splenectomy increases on principle and for life the risk to die of a foudroyant postsplenectomy infection, the so called OPSI-syndrome. The main factors determining the frequency of the OPSI-syndrome are the age at time of operation and the indication for splenectomy. Postsplenectomy infection is mostly caused by pneumococci. In general the important pathophysiological factors are a lack of filtration capacity, a decreased opsonisation activity and a deficiency of early immunoglobulin production. The increased risk of children is probably caused by a physiologically reduced immune response and a cumulation of primary infections. In the foudroyant course of postsplenectomy infection therapy is mostly taken not in time, and mortality ranges between 50 and 80%. For this reason it is necessary to stress prophylaxis as: antibiotics, vaccination, autotransplantation and preserving surgery. The effectivity and application of these prophylactic measurements are clearly limited. Therefore it is very important to inform all patients and their parents about the low, but lifelong risk of infection following splenectomy in order to begin the antibiotic therapy as soon as possible even in cases of banal infections. In expert opinion about the loss of spleen the real situation of the splenectomized individual has to be regarded in making very precise analysis of the course of disease. This has to be done in considering the branch of insurance ordering the opinion (legal accident insurance, legal pensions insurance, social compensation law, private accident or life insurance). If infections or other illness often appear after splenectomy, these have to recognized as resulting impairment, provided that other causes have been excluded. In uncomplicated course it is not justified to suppose disability only by immanent risk.

Expert Testimony↗