Barriers to applying for medical rehabilitation: a time-to-event analysis of employees with severe back pain in Germany

Objective: Longitudinal studies on barriers to applying for rehabilitation in Germany are lacking in light of the suspected underutilization of rehabilitation services. The aim of this study was to examine application behaviour in persons with disabling back pain and to identify relevant predictors for making an application. Design: A prospective cohort study with randomized sampling of insurants in the German Pension Insurance, using a questionnaire at baseline and follow-up with linked administrative data for 1.5 years. Subjects/patients: Employed persons (age range 45–59 years) with a high degree of limitations due to back pain and a self-reported risk of permanent work disability (not applied for disability pension, no medical rehabilitation within the last 4 years). Methods: Multivariable Cox regression was used to examine the influence of pre-selected variables on making an application in the follow-up period. Results: Of 690 persons, only 12% applied for rehabilitation. Predictors for making an application were: support from physicians (hazard ratio (HR)=2.24; 95% confidence interval (95% CI) 1.32–3.80), family, and friends (HR=1.67; 95% CI 1.02–2.73), more pain-related disability days (HR=1.02; 95% CI 1.01–1.03), and worse work ability (HR=0.86; 95% CI 0.75–0.97). An intention to apply at baseline mediated the effect of family and physician support on the application. Conclusion: The low number of applications for rehabilitation despite disabling back pain indicates access barriers to, and underuse of, medical rehabilitation.

Does Social Insurance Block the Inter-Generational Transmission of Poverty? Evidence from the 2018 China Family Panel Survey

In this research, we explored whether participation in pension insurance and medical insurance for children and fathers blocks the inter-generational transmission of poverty. Using data from the China Family Panel Survey of 2018, this paper took the average level of insurance participation of a sample group as an instrumental variable, applied the IV-probit model, and found that the participation of children in pension insurance and the participation of fathers in medical insurance significantly reduce the probability of the inter-generational transmission of poverty, but that the participation of children in medical insurance and the participation of fathers in pension insurance increase it. These results were robust. Furthermore, there was heterogeneity in household registration, geographical location, and marriage with regard to the impact of social insurance participation on the inter-generational transmission of poverty. These results could help the formulation of anti-poverty policies to address the inter-generational transmission of poverty.

PRINCIPLE OF (NON) CUMULATION, THAT IS, ABOUT THE CONFLUENCE OF THE RIGHT TO A RETIREMENT PENSION FROM THE GENERAL AND MILITARY SYSTEMS

Professional soldiers have their own social security system, separate from the general social insurance system, which provides social protection in the event of long service, total incapacity to serve and the death of the breadwinner (pension benefits). At the same time, a professional soldier can accumulate and receive two pensions from different systems, ie universal and reserve. However, the principle of accumulation of benefits based on the applicable provision is dedicated to a narrow group of entitled persons. The principle of non-cumulation is considered to be the basic and dominant one. It is an expression of the principle of risk solidarity in force in social insurance law and is not inconsistent with the constitutional principle of equality expressed in Art. 32 of the Polish Constitution. In the event of the overlapping of the right to several benefits specified in the Act, the pension authority is obliged to pay only one (higher) benefit, even if this right results from various acts, and the possibility of combining benefits must be clearly indicated in the provisions of law. Separation of the insurance and supply system allows each of these systems to fulfill separate obligations towards professional soldiers, not related to the general system. Maintaining the principle that for the same period of retirement pension insurance, two retirement benefits cannot be awarded simultaneously (Article 5 (2a) (2a) of the Pension Act). The exception to the principle of non-accumulation (ie the principle of collecting one benefit) in the case of a professional soldier remaining in service before January 2, 1999 is not determined by the date of admission to service, but the lack of the possibility to calculate the military pension taking into account the “civil” retirement age. The convergence of the right to benefits (from the general and military pension) with the parallel occurrence of these events is contrary to the constitutional principle of social justice. It is not socially just to deprive an insured person who has met the statutory requirements of the right to benefits solely on the basis of social solidarity. In such situations, a significant part of the retiree’s professional life is not reflected in the amount of received retirement benefits.

Internal Migration Experience and Depressive Symptoms among Middle-Aged and Older Adults: Evidence from China

Background: This study aimed to examine the association of internal migration experience with depressive symptoms among middle-aged and elderly Chinese, as well as explore possible mechanisms of the relationship. Methods: Participants were from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative sample of residents aged 45 years and older (n = 43,854). Survey data on depressive symptoms and internal migration experience were collected from biennial CHARLS surveys (CHARLS 2011/2013/2015) and a unique CHARLS life history survey in 2014, respectively. Multiple logistic regressions and the Karlson–Holm–Breen (KHB) method were employed in the statistical analyses. Results: The overall prevalence rate of depressive symptoms among middle-aged and older adults was 34.6%. Internal migration experience was associated with higher risks of depressive symptoms (OR = 1.07, 95% CI = 1.02–1.12, p < 0.01), especially among females (OR = 1.08, 95% CI = 1.01–1.14, p < 0.05), middle-aged adults (OR = 1.12, 95% CI = 1.06–1.19, p < 0.001), rural-to-urban migrants who had not obtained an urban hukou (OR = 1.13, 95% CI = 1.07–1.19, p < 0.001), and those who had low migration frequency and first migrated out at 35 years of age or older. Chronic disease (17.98%, p < 0.001), physical injury (7.04%, p < 0.001), medical expenditure (7.98%, p < 0.001), pension insurance (4.91%, p < 0.001), and parent–child interaction (4.45%, p < 0.01) were shown to mediate the association of internal migration experience with depressive symptoms. Conclusions: This study indicates that there is a significant association between internal migration experience and high risks of depression onset later in life. It is suggested to reduce institutional barriers for migrants and implement evidence-based interventions to improve migrants’ mental health.

Macroeconomic instability – unemployment

In the Ukrainian economy there is a steady growing trend of the actual values of the indicator «unemployment rate». The main causes of excessive unemployment in the Ukrainian economy are three crises: a) crisis of 2008–2009, caused by the global financial crisis; b) crisis of 2014–2015, caused by the military aggression of the Russian Federation; c) crisis of 2020 caused by the COVID-19 pandemic. Economic crises cause a decline in economic activity and falling demand for labor. A particularly negative trend is the growth of unemployment in the age group 35–49. It concentrates the most experienced and highly productive workforce. The Ukrainian economy is receiving a double crisis blow - reduction in production due to the recession and reduction of social labor productivity due to the emigration of the most experienced and highly productive employees. The same problem arises due to rising unemployment in the group of experienced labor aged 50 to 59 years. Once again, there is an urgent need to point out the aggravation of the problem of the deficit of the Pension Fund of Ukraine. After all, the aging of the country's population, rising unemployment and labor emigration cause an increase in the pension burden per employee. This can eventually lead to the collapse of the current pension insurance system. at some stage, a significant part of future retirees, who today in good faith pay contributions to the PFC as employed, will not have anything to pay a pension. On a sectorial basis, the main factors in the growth of unemployment are the decline in production in industry and construction. An increase in capital investment does not lead to a decrease in unemployment. This paradox is explained by the fact that the absolute amount of capital investment in the Ukrainian economy is so small that it does not cause a significant impact on employment growth and unemployment reduction. The main vectors of the state employment policy are: stimulation of industrial production and construction, radical improvement of the investment climate in the Ukrainian economy.

Pensions, Ageing and Social Security Research: Literature Review and Global Trends

Pension systems are one of the fundamental pillars of the welfare state. The ageing of the population caused by longer life expectancy and low birth rates has led to a crisis in the public pension system in developed countries. Changes for the system’s sustainability are necessary, and the scientific literature on the subject is abundant, especially in recent years. This article aims to carry out a bibliometric analysis of the research carried out to date, highlighting, in turn, future lines of research. The study was carried out on a total of 1287 articles published from 1936 to 2021 and found in the Scopus database. The SciMAT, VOSviewer, and Datawrapper tools were used to analyse the most important articles, authors, countries, and institutions by volume of production and citations, as well as the relationships between them. Likewise, the most important keywords and their evolution over time were highlighted, obtaining the main focus of the research. In addition to the general analysis, a specific study was carried out in the area of Mathematics. The results show that the leading countries are the United Kingdom, the USA, and the Netherlands. On the other hand, the lead subject area in which these articles have been published is Economics, Econometrics, and Finance. The research trends are sustainability, pension reform related to ageing, and pension insurance.

Vývoj důchodového pojištění na území dnešní ČR od počátku 20. století po současnost

The article deals with the problems of pension insurance in the territory of today’s Czech Republic from the beginning of the 20th century to the present. The main principles of the development of the pension system in the given period were identified and the analysis was performed mainly in terms of the personal and material scope of insurance, insurance obligations, and briefly in terms of the organizational security of the pension system as well. This analysis was carried out in four selected periods. At the end of the article, the relevant findings from this historical development are summarized and with their use the author's own proposal for the development of the pension insurance system in the Czech Republic in the future is presented.

The Effect of the New Rural Social Pension Insurance Program on the Choice of Medical Institutions for Rural Elderly

To explore the effect of the New Rural Social Pension Insurance (NRSPI) program on the choice of medical institutions for rural elderly is not only an effective entry point to test the influence of the NRSPI program, but also plays an significant role in maintaining people's health, improving our nation’s retirement pension system and the construction of the new countryside. To this end, based on the five periods of Chinese Family Panel Studies (CFPS) data from 2010 to 2018, this paper used Logit model and DID model to empirically investigate the impact of the NRSPI program on the choice of medical institutions for rural elderly. The empirical results show that: first, the NRSPI program can significantly promote the rural elderly to choose higher level of medical institutions for medical treatment. Specifically, receiving the NRSPI pension will increase the probability of rural elderly choosing hospitals at the county level and above by 8.6%, the hospitals at the township level by 2.5%, and will decrease the likelihood of choosing hospitals at the village level by 5.5%.Second, the effects of the NRSPI program are heterogeneous. Compared with the rural elderly in high income families, the program has a greater impact on the choice of medical institutions for those in low income families. Compared with the rural elderly in the eastern region, the program has a greater impact on the selection of county level hospitals and above by those in the central and western regions, but has less impact on the selection of village level hospitals.

Monetary and Non-Monetary Poverty within Urban Locals and Rural Migrants in China using Inequality-Sensitive Poverty Measures

This paper measures monetary and non-monetary poverty among urban local and rural migrant groups in the urban labour market in China, capturing incidence, intensity and inequality of poverty. To measure non-monetary poverty in multiple dimensions the chosen indicators are education, health status, health insurance and pension insurance. Using data from the China Household Income Project for the years 2002, 2007, and 2013, it appears that although monetary poverty in both groups is low, migrants have higher levels of non-monetary deprivation for various levels of poverty thresholds. Compared to the urban locals, the rural migrants experienced relatively less severe poverty than mild or moderate poverty during 2002 and 2007. Our Shapley decomposition exercise on non-monetary poverty measure reveals that the incidence contributes most to the urban-migrant gap, and the contribution of intensity is higher than that of inequality. The most important factors in multidimensional poverty for both groups are health insurance and pension insurance in all years. Our logit analysis shows that the effects of demographic characteristics, level of contract, occupation, and the industry have different impacts on these two groups.

Formation of legislation on pension insurance in France, Great Britain, and Russia. A retrospective

The relevance of the study is due to the crisis of modern pension insurance systems and the need to change the paradigm of pension legislation development. The purpose of the study is to identify the features of the formation of legislation on pension insurance in several countries (France, Great Britain, and Russia) at the initial stage of development (before 1914). The novelty is expressed both in the formulation of the problem and in the research methodology (the choice of countries and the period of research, the justification for the use of methods: dialectics, analysis, synthesis, system-structural, sociological, statistical, historical-legal, comparative-legal, formal-legal). The result of the study was the conclusions about the historical conditionality of the peculiarities of the formation of legislation on pension insurance in a particular country. There was early legalization of both voluntary and compulsory pension insurance in France. There was no legislation on pension insurance in the UK during the period under review, despite the early development of relevant institutions in the framework of workshops, guilds, and later in the framework of trade unions and “friendly societies”. In Russia, due to the agrarian nature of the economy, pension insurance did not develop within the framework of workshops and guilds; there were no laws on insurance in case of old age by 1914, while the risks of disability and loss of the breadwinner were regulated by law.