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Contribution à la validation d’instruments de mesure de la dépendance des personnes âgées.Falez, Freddy L.A. 22 November 2006 (has links)
Résumé.
Introduction.
Le premier chapitre de l’introduction expose les problèmes posés à la sécurité sociale par le vieillissement de la population et plus particulièrement par le développement de la dépendance des personnes âgées. Ces problèmes sont illustrés par l’évolution des dépenses en soins de santé pour les aides aux actes de la vie journalière en institutions d’hébergement des personnes âgées, et à domicile.
Le deuxième chapitre décrit les instruments d’évaluation qui sont étudiés dans la présente dissertation. En effet, en Belgique, le financement des soins à la dépendance est réalisé sur base d’une évaluation à l’aide d’une échelle de l’INAMI ; une allocation à la personne âgée peut être obtenue par les personnes âgées dont la dépendance est alors évaluée à l’aide de l’échelle de la prévoyance sociale que nous appellerons aussi APA. Nous les comparons à l’outil d’évaluation utilisé en France et dénommé AGGIR pour autonomie gérontologique, groupes iso-resources.
Méthodes et populations.
Méthodes.
Nous validons les trois instruments sur le plan du construit à l’aide la Classification Internationale du Fonctionnement (CIF) de l’OMS. La validité est évaluée de différentes manières : validité concurrentielle entre les trois instruments ; validité concomitante des trois instruments par comparaison aux temps de soins nécessaires par les méthodes de corrélation, , leur capacité de discriminer des catégories de dépendance ; la fidélité des instruments est également étudiée.
Populations
Quatre enquêtes ont été réalisée : la première en institutions de personnes âgées, la seconde à domicile, la troisième à domicile et la quatrième en institutions de personnes âgées avec la collaboration de différents professionnels : infirmières soignantes, infirmiers conseils de mutualité et l’auteur de la dissertation.
Résultats.
La troisième partie de la dissertation expose les résultats démographiques et des tests de validation.
Discussion.
La quatrième partie évalue les résultats. L’échelle de l’INAMI est de conception ancienne pour son contenu. Sa validité est suffisante pour étudier les charges en soins de populations de patients mais insuffisantes pour l’évaluation des besoins individuels, car elle n’évalue pas les besoins pour les actes instrumentaux de la vie journalière.
L’échelle APA a une mauvaise validité de contenu ; sa validité de construit est la moins bonne des trois instruments étudiés. Sa fidélité est médiocre. Cette échelle est à déconseiller.
La grille AGGIR a une validité de contenu moderne et bonne, une bonne validité de construit et une bonne fidélité.
Conclusions.
Des trois instruments étudiés, la grille AGGIR est la plus performante et permet à la fois le financement des soins à des populations des patients et l’évaluation de critères d’éligibilité pour l’octroi d’avantages sociaux.
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Imunidade tributária às contribuições sociais destinadas à segurança social das entidades beneficientes de assistência social / Tax immunity on social insurance contributions for the social security of the charitable organization for social assustanceGonçalves, Rodrigo Prado 19 February 2015 (has links)
O presente trabalho científico possui por escopo estudar a imunidade tributária às contribuições sociais destinadas à seguridade social das entidades beneficentes de assistência social mencionada no artigo 195, §7º, da Constituição Federal de 1988, bem como a abrangência dessa hipótese imunitória aplicável a essas espécies de entidades sem fins lucrativos. A imunidade tributária é uma norma de estrutura contida na Constituição Federal de 1988 que impede que União, Estados, Distrito Federal e Municípios tributem certas pessoas, fatos ou bens. Em outras palavras, as imunidades tributárias são normas constitucionais de incompetência tributária. A Constituição Federal de 1988 elenca inúmeras espécies de imunidades tributárias, dentre as quais a imunidade às contribuições sociais destinadas à seguridade social das entidades beneficentes de assistência social. Sempre que determinada pessoa jurídica enquadrar-se no conceito de entidade beneficente de assistência social e observar as exigências contidas na lei será ela imune. De acordo com a Carta Magna de 1988, consideram-se entidades beneficentes de assistência social as pessoas jurídicas que promovem as ações descritas em seu artigo 203. Neste trabalho científico, analisaremos se farão jus à imunidade tributária às contribuições sociais destinadas à seguridade social somente as entidades que possuem por objetivo as ações descritas no artigo 203 ou se o conceito de entidade beneficente de assistência social é mais abrangente. Afora enquadrar-se no conceito de entidade beneficente de assistência social, a instituição, para fins de fruição da imunidade às contribuições sociais destinadas à seguridade social, deve preencher alguns requisitos dispostos em lei. Mas que lei vem a ser esta: ordinária ou complementar? Consoante será demonstrado ao longo deste trabalho científico, tal lei só pode ser a complementar, haja vista esse ser o único instrumento normativo apto a estabelecer os requisitos a serem preenchidos visando ao gozo da imunidade às contribuições sociais destinadas à seguridade social, não obstante esse não ser o entendimento atual de grande parte dos integrantes do Poder Judiciário Brasileiro. / This Masters Thesis aims at studying the tax immunity on social insurance contributions for the social security of those charitable organization for social assistance mentioned in section 195, §7 of the 1988 Federal Constitution, as well as the extent to which this hypothesis of immunity may be applicable to these types of non-profit making entities. Tax immunity is a structural regulation included in the 1988 Federal Constitution that prevents the Union, States, Federal District and Municipalities from taxing certain persons, events or assets. In other words, the tax immunities are constitutional norms establishing the non-applicability of taxes. The 1988 Federal Constitution lists a number of types of tax immunities, amongst which is the immunity to social insurance contributions for the social security of charitable organizations for social assistance. A company shall be declared immune whenever it is understood to fit into the concept of a charitable organization for social assistance and whenever it meets the requirements established by law. According to the 1988 Federal Constitution, charitable organizations for social assistance are considered to be those companies that perform the activities described in its article 203. In this Masters Thesis, we will be analyzing whether it is fair for the tax immunity on social insurance contributions for social security to be applicable only to those organizations with the objectives described in section 203, or if the concept of a charitable organization for social assistance is more wide reaching. Besides fitting into the concept of a charitable organization for social assistance, the organization, in order to take advantage of the immunity from social insurance contributions for social security, must meet all the requirements established by law. But which law should this be: an ordinary law or a complimentary law? Accordingly, it is to be demonstrated over the course of this Masters Thesis that a complimentary law can be the only one applicable, since this is the only regulatory instrument able to establish the requirements that need to be met to take advantage of the immunity to social insurance contributions for social security, despite this not being the current understanding of the majority of those forming the Brazilian Judiciary.
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Den nya rehabiliteringskedjan och arbetslivsinriktad rehabilitering ur försäkringskassahandläggarens perspektivVikblom, Ines January 2010 (has links)
<p>Den nya rehabiliteringskedjan med sina fasta tidsgränser för långtidssjukskrivna har fått stor uppmärksamhet i svensk media under senare tid. De nya reglerna fokuserar framförallt på tidiga insatser för långtidssjukskrivna med målet återgång i arbete. Intervjuerna i föreliggande studie utfördes med sju försäkrings-kassahandläggare på olika försäkringskontor. Syftet var att undersöka vilka erfarenheter och upplevelser handläggarna på Försäkringskassan har av den nya rehabiliteringskedjan och arbetslivsinriktad rehabilitering. Resultatet visade att det är en mängd olika faktorer som påverkar handläggarnas arbete. Som viktiga faktorer uppgav handläggarna ett ändrat regelverk med fasta tidsgränser, samarbetet mellan olika aktörer för den försäkrades återgång i arbete, handläggarnas och andra aktörers engagemang samt den försäkrades egna resurser. Vidare forskning inom området arbetslivs-inriktad rehabilitering behövs, om den nya rehabiliteringskedjans effekter på tidigare återgång till arbetslivet verkligen innebär ökat stöd till de långtidssjukskrivna. Även andra rehabiliterings-aktörers erfarenheter av de nya sjukskrivningsreglerna behöver utforskas.</p>
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En privatisering av arbetsskadeförsäkringen / A Privatisation of the Work Injury InsuranceKilic, Mariya, Svensson, Kristina January 2000 (has links)
The main purpose of this thesis is to analyse the possibilities and problems facing a privatised work injury insurance. This discussion includes the element of premium differentiation. Todays´ Swedish social insurance system is ineffectively formed. The costs have dramatically increased during the 1990´s. The Swedish government is now looking for ways to improve the efficiency of the system. The work injury insurance has not followed this pattern of increased costs. On the other hand there are reasons to believe that many of the costs derived from work injuries have been allocated o burden other social insurance. This is one of the distortions in which the system results. With focus on a privately financed work injury insurance the aim is to increase the fairness of the social insurance system. The allocation of cost burdens on the right party is included in this aim. It is believed that the motive of prevention for an injury to occur and the efforts in rehabilitation will improve when introducing a private work injury insurance. More responsibility is given to the insured, i. e. the employer. Private insurance companies can specialise and are, on a competitive market, able to keep the premiums on a fair price level. The conclusion is that efficiency can, in several aspects, increase when introducing a privately financed work injury insurance.
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Den nya rehabiliteringskedjan och arbetslivsinriktad rehabilitering ur försäkringskassahandläggarens perspektivVikblom, Ines January 2010 (has links)
Den nya rehabiliteringskedjan med sina fasta tidsgränser för långtidssjukskrivna har fått stor uppmärksamhet i svensk media under senare tid. De nya reglerna fokuserar framförallt på tidiga insatser för långtidssjukskrivna med målet återgång i arbete. Intervjuerna i föreliggande studie utfördes med sju försäkrings-kassahandläggare på olika försäkringskontor. Syftet var att undersöka vilka erfarenheter och upplevelser handläggarna på Försäkringskassan har av den nya rehabiliteringskedjan och arbetslivsinriktad rehabilitering. Resultatet visade att det är en mängd olika faktorer som påverkar handläggarnas arbete. Som viktiga faktorer uppgav handläggarna ett ändrat regelverk med fasta tidsgränser, samarbetet mellan olika aktörer för den försäkrades återgång i arbete, handläggarnas och andra aktörers engagemang samt den försäkrades egna resurser. Vidare forskning inom området arbetslivs-inriktad rehabilitering behövs, om den nya rehabiliteringskedjans effekter på tidigare återgång till arbetslivet verkligen innebär ökat stöd till de långtidssjukskrivna. Även andra rehabiliterings-aktörers erfarenheter av de nya sjukskrivningsreglerna behöver utforskas.
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The Balance of the Obligation of National Care and National Financial Capability on the Legal Basis of Long-term Care in Taiwan A StudyWu, Shu-Ling 08 September 2011 (has links)
A modern democratic nation is responsible to taking care its people¡¦s basic needs. This is not only the essential reason for the existence of a nation, but also its responsibility and obligation. The right to life is an important issue in international treaties and constitutions of variable nations. People are entitled to claim care from their countries to maintain a reasonable living standard. Countries are obliged to safeguard its people¡¦s right to life through legislation, to provide basic living needs which meet human nature dignity.
A nation has many obligations include the maintaining of individual health, ensuring sound environment, social relief and social insurance. Financial operation is a key issue in managing a nation. Therefore, in fulfilling the obligations, a nation must consider its financial affordability seriously so as not to deteriorate its finance for overly taking care of its people.
Due to rapid aging of population and low fertility, Japan implemented Long Term Care Insurance in 2000; however, many a relative legal issue was encountered while conducting such system. For instance, for the purposes of convenience and efficiency in collecting premiums, a special levy is applied to 90% of No. 1 insurees whose age were over 65, the premiums were pre-deducted from their perpetual pensions, which may cause the qualms about trenching on the capability of people to maintain a lowest living standards and the abuse of the power of administrative decision. Eyed on financial consideration, Japanese government carried out the Law for Long Term Care Insurance, refuses its service to those whose premiums were over due, and suppresses the accessibility for the poor. The group that was supposed to be taken care of by the government is totally neglected while the middle class taking advantages from the system and waste more public fund. This is completely opposite to the objectives of the long term care system legislation. This also caused the disputes that the right to life regulated in the article 25 of Japanese Constitution is violated by administrative power.
Our nation is confronted with population aging and low fertility as well lately. The total fertility rate has declined to 0.895, which is the lowest in the world. In the aging society, the long term care need of the elders and the disabled, and related heavy financial burdens are already far beyond the capacities of individuals or families and become a ¡§Social Risk.¡¨ Such a risk will need a coercive risk managing technique enforced by the nation, to organize a social insurance structure so as to share the risk and reduce individuals¡¦ burdens.
Our government is engaging in planning a long term care system. The flaws of Japan¡¦s Law for Long Term Care Insurance, both in legislation and enforcement, can be valuable lessons for us. This essay discussed the legalization of the long term care system of our nation, reviewed its jurisprudence and raised integrated long term care concept. Some suggestions concerned with operation subject, insurance objects and financial plans were provided in hope with a comprehensive guideline on policy making, legislation and enforcement and system construction can be established.
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En privatisering av arbetsskadeförsäkringen / A Privatisation of the Work Injury InsuranceKilic, Mariya, Svensson, Kristina January 2000 (has links)
<p>The main purpose of this thesis is to analyse the possibilities and problems facing a privatised work injury insurance. This discussion includes the element of premium differentiation. Todays´ Swedish social insurance system is ineffectively formed. The costs have dramatically increased during the 1990´s. The Swedish government is now looking for ways to improve the efficiency of the system. The work injury insurance has not followed this pattern of increased costs. On the other hand there are reasons to believe that many of the costs derived from work injuries have been allocated o burden other social insurance. This is one of the distortions in which the system results. With focus on a privately financed work injury insurance the aim is to increase the fairness of the social insurance system. The allocation of cost burdens on the right party is included in this aim. It is believed that the motive of prevention for an injury to occur and the efforts in rehabilitation will improve when introducing a private work injury insurance. More responsibility is given to the insured, i. e. the employer. Private insurance companies can specialise and are, on a competitive market, able to keep the premiums on a fair price level. The conclusion is that efficiency can, in several aspects, increase when introducing a privately financed work injury insurance.</p>
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Från gemenskap till individualism : om pensionerade statstjänstemän i Sverige / From fellowship to individualism : how Sweden's elderly fared after the warBjörklund, Carl Henry January 2015 (has links)
Uppsatsen handlar om den lokala föreningen i Västerås av SPRF, Sveriges Pensionärers Riksförbund. En utblick görs till det socialpolitiska förvärvet från tidigmodern tid. Under femtiotalet fanns en social och ekonomisk gemenskap. Den har genom Socialförsäkringsbalken 2010 förbytts i individualism när pensionen direkt och entydigt tillhandahålls av staten. / How Sweden's elderly fared after the war. Focus is on public officials in Västerås, a provincial capital one hour's drive west of Stockholm. Arriving from the collective spirit of the fifties, the individual can no longer elicit any economic incentive from any entity positioned between him and the state.
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Lietuvos pensijų fondų raidos analizė / Analysis of evoliution of the Lithuanian pension fundsLabulienė, Violeta 21 December 2006 (has links)
Baigiamajame darbe darbo autorė apžvelgia Lietuvos pensijų fondų raidą. Darbe išskiriami tokie pagrindiniai aspektai: istorinė pensijų fondų atsiradimo apžvalga, pensijų fondų veikla, pensijų fondų klasifikavimas ir veiklos ypatumai, pensijų fondų analizė. Panaudodama Lietuvos Respublikos pensijų kaupimo veiklą reglamentuojančius įstatymus, kitą reikalingą medžiagą ir surinkus duomenis apie pensijų fondus, darbo autorė išanalizavo pensijų fondų atsiradimo eigą, suklasifikavo pensijų fondus į grupes, pagal investicijų į akcijų rinkas dalį. Atlikus dalyvių pasiskirstymą tarp pensijų kaupimo veiklą vykdančių įmonių, darbo autorė išnagrinėjo kokioms bendrovėms Lietuvos gyventojai labiau patiki valdyti savo lėšas. Atlikus dalyvių pasiskirstymą pagal investavimo strategijas, autorė sužinojo kokius pensijų fondus žmonės linkę pasirinkti. / Referring to the laws of the Republic of Lithuania, which regulate the pension accumulation activity, the other necessary material and the collected data about pension funds, the author of the thesis has analyzed the course of founding of pension funds, has classified pension funds according to the groups, according to the investment share in the share market. After having distributed the participants among the enterprises, which execute the pension accumulation activity, the author of the thesis has investigated the item, i.e. the enterprises, which are mostly trusted by the dwellers of Lithuania from the aspect of management of their means. After having distributed the participants according to the investment strategy, the author has ascertained which pensions funds are mostly popular among people.
According to the analysis, which has been done by the author of the thesis, founding of the new pension funds of the II-nd and of the III-rd level is observed. Several large-scale enterprises of the country have expanded the offer of their funds by founding the investment funds, attributed to a larger risk, which invest most their assets into the shares.
The author of the thesis would like to stress that a larger number of funds means a tough competition regarding the clients. It’s useful as the increased number of funds urges the pension accumulating enterprises to improve the quality of management, to submit a more specified and various information about their activity. An... [to full text]
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Socialinio draudimo plėtros analizė Lietuvoje / The analysis of social insurance development in LithuaniaValiulis, Kęstutis 22 December 2006 (has links)
Socialinio draudimo sistema Lietuvoje, esama padėtis, pensininkų problemos bei galimi jų sprendimo būdai - tai dalis klausimų, kylančių Lietuvos gyventojams. Visuomenės senėjimas ir tai, kad kiekvienas dirbantysis ateityje bus pensininku, pabrėžia temos aktualumą. Šiame darbe keliama hipotezė, kad tokie ekonominiai ir socialiniai veiksniai, kaip BVP, ekonomikos augimas, darbo užmokesčio didėjimas, pensinio amžiaus ilgėjimas, privačių pensinių fondų plėtra, gyventojų skaičiaus kitimai yra tarpusavyje tampriai susiję ir sąlygojantys vienas kitą bei pačios socialinio draudimo sistemos kitimus ir jos plėtra. Darbe buvo nagrinėtas 1991-2006 metų laikotarpis. Jo metu vyko privatizacijos procesai, keitėsi gyventojų užimtumas, prasidėjo ekonominė emigracija, prasidėjo privačių pensinių fondų vystymasis. Tai keitė žmonių užimtumą, darbo užmokestį, pensinį aprūpinimą. / The social insurance system in Lithuania, the present status, the problems of the pensioners and the ways to solve these problems – this is only the part of the questions, which are relevant for the Lithuanians. The ageing of the community and knowing that every working man will become the pensioner in the future accents the topicality of the problem. The hypothesis in this paper is about such economic and social factors as GDP (Gross Domestic product), the increase of economy and salaries and the elongation of the pensioner age, the development of the private pension’s funds and the variation of the citizens’ number. All these factors are closely involved and influence each other and the variations of the insurance system and development. There are analyzed the period of 1991-2006, November in this paper. The privatization processes began at that time, the occupation of citizens changed, economy emigration began, and development of private funds began. These variations changed the people occupation, the salaries, pensioner supply.
In the present the new society ageing problems are coming. Even when the pensions age after the independence was prolonged from 55 to 60 for the women and from 60 to 62,5 for the men, this decision does not deal with the problems of ageing society. The old-age pension’s size is not large enough to guarantee better living quality for the elderly people. The work reserve of the elderly people is not used too. These elderly people want to work, but... [to full text]
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