Wage Continuation During Sickness: Observations on Paid Sick Leave Provisions in Times of Crises

[Excerpt] The economic costs of working while sick go far beyond increased health care costs due to treating a significantly higher number of people showing more severe signs of ill health. They also involve costs due to lower productivity and subsequent impacts on economic growth and development, in addition to collective costs of growing health and social inequalities. However, many aspects of social health protection including the role, patterns and costs of paid sick leave are misunderstood or underappreciated especially during times of economic crisis and recession. It is often said that paid sick leave schemes are open to abuse, especially if the benefit levels appear generous. This is undoubtedly a danger, and points to the need for strong administration. However, it is all too easy to overstate the case. ILO analyses of stimulus packages and policies addressing the crises reveal that cuts of social and health budgets are among the first national responses to recover the costs of bailing out those that have contributed to the crisis. Concerned are social health protection measures that provide access to health services and financial protection in case of sickness, such as paid sick leave. Limited evidence is available for governments, employers and workers’ unions on the consequences of gaps in providing for paid sick leave and costs of failing to address the needs of the vulnerable. Developing reliable internationally comparable data is constrained by the complex interplay of health and socio-economic conditions including regulations, labour market structure and vulnerability when taking up paid sick leave. Against this background, this paper seeks to focus on the existing national and international evidence and provides some insights into the concepts, patterns and affordability of paid sick leave in countries throughout the world. Further, it is argued that providing for sick leave and related income replacement is a key component of decent work and should be considered within national social protection floors

Evidence on paid sick leave: Observations in times of crisis

A large number of governments in all regions of the world have recognised the need for paid sick leave although the benefi t schedules vary widely. International data show that the incidence of paid sick leave is closely associated with overall economic developments. What are the patterns of paid sick leave and its incidence around the world, and how have these been affected by the recent economic crisis

An open platform for seamless sensor support in healthcare for the Internet of things

Population aging and increasing pressure on health systems are two issues that demand solutions. Involving and empowering citizens as active managers of their health represents a desirable shift from the current culture mainly focused on treatment of disease, to one also focused on continuous health management and well-being. Current developments in technological areas such as the Internet of Things (IoT), lead to new technological solutions that can aid this shift in the healthcare sector. This study presents the design, development, implementation and evaluation of a platform called Common Recognition and Identification Platform (CRIP), a part of the CareStore project, which aims at supporting caregivers and citizens to manage health routines in a seamless way. Specifically, the CRIP offers sensor-based support for seamless identification of users and health devices. A set of initial requirements was defined with a focus on usability limitations and current sensor technologies. The CRIP was designed and implemented using several technologies that enable seamless integration and interaction of sensors and people, namely Near Field Communication and fingerprint biometrics for identification and authentication, Bluetooth for communication with health devices and web services for wider integration with other platforms. Two CRIP prototypes were implemented and evaluated in laboratory during a period of eight months. The evaluations consisted of identifying users and devices, as well as seamlessly configure and acquire vital data from the last. Also, the entire Carestore platform was deployed in a nursing home where its usability was evaluated with caregivers. The evaluations helped assess that seamless identification of users and seamless configuration and communication with health devices is feasible and can help enable the IoT on healthcare applications. Therefore, the CRIP and similar platforms could be transformed into a valuable enabling technology for secure and reliable IoT deployments on the healthcare sector.This research work was supported under the European Framework Program FP7 Research for the Benefit of SMEs, project FP7-SME-2012-315158-CareStore. The authors would also like to acknowledge the work of all the members of the CareStore team, without whom this work would not be possible

Students' perceptions of the instructional quality of district hospital-based training.

Background: An innovative, three-year training programme, the Bachelor of Clinical Medical Practice (BCMP), for mid-level medical healthcare workers was started in 2009 by the Department of Family Medicine, University of Pretoria. Aim: To measure the students’ perceptions of the instructional quality of district hospitalbased training. Setting: Training of students took place at clinical learning centres in rural district hospitals in the Mpumalanga and Gauteng provinces. Methods: A survey using the MedEd IQ questionnaire was performed in 2010 and 2011 to measure BCMP second- and third-year students’ perceptions of instructional quality of district hospital-based training. The MedEd IQ questionnaire is composed of four subscales: preceptor activities, learning opportunities, learner involvement and the learning environment. Composite scores of instructional quality were used to present results. Results: The preceptor activities, learning opportunities and the learning environment were considered by second- and third-year BCMP students to be of consistently high instructional quality. In the area of learner involvement, instructional quality increased significantly from second to third year. Conclusion: Overall, instructional quality of district hospital-based training was high for both second- and third-year BCMP students, and the instructional quality of learner involvement being significantly higher in third year students. The MedEd IQ tool was a useful tool for measuring instructional quality and to inform programme quality improvement. Keywords: clinical associates, evaluation of medical education, mid-level healthcare workers, rural learning centres, rural medical education, student satisfaction

Health financing reform in Kenya- assessing the social health insurance proposal

Kenya has had a history of health financing policy changes since its   independence in 1963. Recently, significant preparatory work was done on a new Social Health Insurance Law that, if accepted, would lead to universal health coverage in Kenya after a tr&nsition period. Questions of economic  feasibility and political acceptability continue to be discussed, with   stakeholders voicing concerns on design features of the new proposal   submitted to the  Kenyan parliament in 2004. For economic, social, political and organisational reasons a transition period will be  necessary, which is likely to last more than a decade. However, important objectives such as access to health care  and avoiding impoverishment due to direct health care payments should be recognised from the start so that  steady progress towards effective universal coverage can be planned and achieved

Disparity in Reimbursement for Tuberculosis Care Among Different Health Insurance Schemes: Evidence from Three Counties in Central China

Background: Health inequity is an important issue all around the world. The Chinese basic medical security system comprises three major insurance schemes, namely the Urban Employee Basic Medical Insurance (UEBMI), the Urban Resident Basic Medical Insurance (URBMI), and the New Cooperative Medical Scheme (NCMS). Little research has been conducted to look into the disparity in payments among the health insurance schemes in China. In this study, we aimed to evaluate the disparity in reimbursements for tuberculosis (TB) care among the abovementioned health insurance schemes. Methods: This study uses a World Health Organization (WHO) framework to analyze the disparities and equity relating to the three dimensions of health insurance: population coverage, the range of services covered, and the extent to which costs are covered. Each of the health insurance scheme’s policies were categorized and analyzed. An analysis of the claims database of all hospitalizations reimbursed from 2010 to 2012 in three counties of Yichang city (YC), which included 1506 discharges, was conducted to identify the differences in reimbursement rates and out-of-pocket (OOP) expenses among the health insurance schemes. Results: Tuberculosis patients had various inpatient expenses depending on which scheme they were covered by (TB patients covered by the NCMS have less inpatient expenses than those who were covered by the URBMI, who have less inpatient expenses than those covered by the UEBMI). We found a significant horizontal inequity of healthcare utilization among the lower socioeconomic groups. In terms of financial inequity, TB patients who earned less paid more. The NCMS provides modest financial protection, based on income. Overall, TB patients from lower socioeconomic groups were the most vulnerable. Conclusion: There are large disparities in reimbursement for TB care among the three health insurance schemes and this, in turn, hampers TB control. Reducing the gap in health outcomes between the three health insurance schemes in China should be a focus of TB care and control. Achieving equity through integrated policies that avoid discrimination is likely to be effective