Changes in the incidence of occupational disability as a result of back and neck pain in the Netherlands

BACKGROUND: Back pain (including neck pain) is one of the most prevalent health problems for which physicians are consulted. Back pain can decrease the quality of life considerably during a great part of the lives of those who suffer from it. At the same time it has an enormous economic impact, mainly through sickness absence and long-term disability. The objective of this paper is to compare the incidence of occupational disability as a result of back and neck pain in 1980–1985 to 1999–2000 and to explain the findings. METHODS: A descriptive study was performed at population level of changes in incidence of occupational disability as a result of back and neck pain. Statistics from the National Institute of Social Insurance in the Netherlands are used to calculate age and gender specific incidence rates for back pain diagnoses based on the ICD-classification. Incidence rate ratios stratified according to gender and adjusted for age were calculated to indicate changes over time. RESULTS: The incidence of occupational disability as a result of back pain decreased significantly by 37% (95% CI 37%–38%) in men and with 21% (95% CI 20%–24%) in women, after adjustment for age. For overall occupational disability as a result of all diagnoses this was 18% (95% CI 18%–19%) and 34% (95% CI 33%–35%) respectively. Changes were not homogeneous over diagnostic subcategories and age groups. Spondylosis decreased most in men by 59% (95% CI 57%–61%). The incidence of non-specific back pain and neck pain increased most by 196% (95% CI 164%–215%). Post-laminectomy syndrome increased over all age categories both for men (85%, 95% CI 61%–113%) and women (113%, 95% CI 65%–179%). CONCLUSION: The decrease in occupational disability as a result of back pain was larger than the decrease in occupational disability over all diagnoses. However, time trends were not homogeneous over age-, nor over sex- nor back pain categories. Most of this decrease was due to general changes such as legal and economic changes. One of several additional explanations for a decrease is the changed view on management of back pain

Health-Based Risk Adjustment: Improving the Pharmacy-Based Cost Group Model by Adding Diagnostic Cost Groups

Since 1991, risk-adjusted premium subsidies have existed in the Dutch social health insurance sector, which covered about two-thirds of the population until 2006. In 2002, pharmacy-based cost groups (PCGs) were included in the demographic risk adjustment model, which improved the goodness-of-fit, as measured by the R 2 , to 11.5%. The model's R 2 reached 22.8% in 2004, when inpatient diagnostic information was added in the form of diagnostic cost groups (DCGs). PCGs and DCGs appear to be complementary in their ability to predict future costs. PCGs particularly improve the R 2 for outpatient expenses, whereas DCGs improve the R 2 for inpatient expenses. In 2006, this system of risk-adjusted premium subsidies was extended to cover the entire population

Blood donor motivators during the COVID-19 pandemic

While donating blood during the COVID-19 pandemic offers individuals a possibility to contribute to their community, donation also exposes donors to additional risks, as physical distancing is impossible during a donation. This study explored what motivated blood and plasma donors in the Netherlands to donate during the COVID-19 pandemic, in order to identify potential focus points for donor recruitment in future crises. In total, 3175 of the invited 7286 donors who donated between 1 and 14 April 2020 participated in an online questionnaire including questions about motivations for blood donation. Motivations for blood donation were compared among donation types, sexes, age groups, and regions. Respondents consisted of 10.6% new, 18.9% whole blood, and 70.5% plasma donors. About 80% of all donors indicated wanting to help COVID-19 patients. Particularly whole blood donors were motivated by a call for donations (90.8%). Plasma donors more often hoped to get tested for SARS-CoV-2 antibodies than new and whole blood donors. Older donors (aged ≥40) more often reported hoping to get tested for SARS-CoV-2 antibodies, wanting to help COVID-19 patients, and thinking that getting infected during the donation process was impossible. Younger donors (aged ≤39) more often indicated that getting out of the house and not having to go to work motivated them to donate. Donors mainly had pro-social motivations to donate during the COVID-19 pandemic, as helping COVID-19 patients was the most important motivator. This shows the promise of explicitly expressing need in times of crisis, for blood banks in particular and philanthropic organizations in general

Associations of self-reported health status with donation intensity—Relative risk (95% confidence intervals).

<p>Associations of self-reported health status with donation intensity—Relative risk (95% confidence intervals).</p

Associations of self-reported health status with time to donation cessation (hazard ratios and 95% confidence intervals), adjusted for age, smoking, baseline donation intensity and new donor status; for men (gray) and women (white).

<p>Time from participation in DIS to donation cessation or censoring (31-12-2013) was calculated in days.</p

Outcomes among the donors during follow-up.

<p>Outcomes among the donors during follow-up.</p

New blood donors in times of crisis:Increased donation willingness, particularly among people at high risk for attracting SARS-CoV-2

Background: Traditionally, during crises the number of new blood donors increases. However, the current coronavirus disease 2019 (COVID-19) pandemic created additional barriers to donate due to governmental prevention measures and increased personal health risks. In this report, we examined how the pandemic affected new donor registrations in the Netherlands, especially among groups with higher risk profiles for severe COVID-19. Additionally, we explored the role of media for blood donation and new donor registrations. Study Design and Methods: We analyzed new donor registrations and attention for blood donation in newspapers and on social media from January until May 2020, in comparison to the same period in 2017 to 2019. Results: After the introduction of nationwide prevention measures, several peaks in new donor registrations occurred, which coincided with peaks in media attention. Interestingly, people with a higher risk profile for COVID-19 (e.g., due to age or region of residence) were overrepresented among new registrants. Discussion: In sum, the first peak of the current pandemic has led to increased new blood donor registrations, despite the associated increased health risks. Time and future studies will have to tell whether these new donors are one-off ‘pandemic’ donors or if they will become regular, loyal donors

Donor InSight: characteristics and representativeness of a Dutch cohort study on blood and plasma donors

BACKGROUND AND OBJECTIVES: More insight into donor health and behaviour may contribute to more efficient and focused strategies regarding donor care and management. Donor InSight (DIS) is a Dutch cohort study of blood and plasma donors. We aimed to outline the objectives and methods of DIS, describe the cohort, and compare it to the active Dutch donor population. MATERIALS AND METHODS: In 2007-2009 (DIS-I, n = 31 338) and 2012-2013 (DIS-II, 34 826, of whom 22 132 also participated in DIS-I) questionnaire data on demographics, donation, lifestyle, family composition, health and disease were collected. A second follow-up (DIS-III, n = 3046), including donors with differing haemoglobin trajectories, was completed in 2015-2016. DIS-III includes data on genetic determinants, iron and red cell indices. Representativeness of the DIS-I sample for the entire Dutch donor population was assessed by comparing characteristics of both. RESULTS: Donor InSight was initially set up because of a need for more detailed information and evidence as a basis for decision-making in blood banks. DIS-I sample is comparable to the total Dutch donor population in terms of age, body mass index, haemoglobin level, blood pressure, blood type and donation behaviour. CONCLUSION: Donor InSight is a cohort study representative of the Dutch donor population. It provides evidence to support evidence-based decision making

Baseline characteristics of whole blood donors in the Donor InSight (DIS) population.

<p>Baseline characteristics of whole blood donors in the Donor InSight (DIS) population.</p

The Healthy Donor Effect in three stages.

<p>HRE = Healthy Registration Effect, HDSE = Healthy Donor Survivor Effect, HDCE = Healthy Donor Career Effect. (Adapted with permission from “Blood Donation and Cardiovascular Disease—Addressing the Healthy Donor Effect”, PhD thesis by K. Peffer, 1-12-2015. ISBN: 978-90-6464-933-2).</p