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Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia

BACKGROUND: The official statistics of persons with mental disorders who are granted disability pension (DP) in Russia and Norway indicate large differences between the countries. METHODS: This qualitative explorative hypothesis-generating study is based on text analysis of the laws, regulations and...

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Autores principales: Rezvyy, Grigory, Schönfelder, Walter, Øiesvold, Terje, Olstad, Reidun, Midré, Georges
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994164/
https://www.ncbi.nlm.nih.gov/pubmed/17705818
http://dx.doi.org/10.1186/1472-6963-7-128
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author Rezvyy, Grigory
Schönfelder, Walter
Øiesvold, Terje
Olstad, Reidun
Midré, Georges
author_facet Rezvyy, Grigory
Schönfelder, Walter
Øiesvold, Terje
Olstad, Reidun
Midré, Georges
author_sort Rezvyy, Grigory
collection PubMed
description BACKGROUND: The official statistics of persons with mental disorders who are granted disability pension (DP) in Russia and Norway indicate large differences between the countries. METHODS: This qualitative explorative hypothesis-generating study is based on text analysis of the laws, regulations and guidelines, and qualitative interviews of informants representing all the organisational elements of the DP systems in both countries. RESULTS: The DP application process is initiated much later in Norway than in Russia, where a 3 year occupational rehabilitation and adequate treatment is mandatory before DP is granted. In Russia, two instances are responsible for preparing of the medical certification for DP, a patients medical doctor (PD) and a clinical expert commission (CEC) while there is one in Norway (PD). In Russia, the Bureau of Medical-Social Expertise is responsible for evaluation and granting of DP. In Norway, the local social insurance offices (SIO) are responsible for the DP application. Decisions are taken collectively in Russia, while the Norwegian PD and SIO officer often take decisions alone. In Russia, the medical criterion is the decisive one, while rehabilitation and treatment criteria are given priority in Norway. The size of the DP in Norway is enough to cover of subsistences expenditure, while the Russian DP is less than the level required for minimum subsistence. CONCLUSION: There were noteworthy differences in the time frame, organisation model and process leading to a DP in the two countries. These differences may explain why so few patients with less severe mental disorders receive a DP in Russia. This fact, in combination with the size of the DP, may hamper reforms of the mental health care system in Russia.
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spelling pubmed-19941642007-09-26 Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia Rezvyy, Grigory Schönfelder, Walter Øiesvold, Terje Olstad, Reidun Midré, Georges BMC Health Serv Res Research Article BACKGROUND: The official statistics of persons with mental disorders who are granted disability pension (DP) in Russia and Norway indicate large differences between the countries. METHODS: This qualitative explorative hypothesis-generating study is based on text analysis of the laws, regulations and guidelines, and qualitative interviews of informants representing all the organisational elements of the DP systems in both countries. RESULTS: The DP application process is initiated much later in Norway than in Russia, where a 3 year occupational rehabilitation and adequate treatment is mandatory before DP is granted. In Russia, two instances are responsible for preparing of the medical certification for DP, a patients medical doctor (PD) and a clinical expert commission (CEC) while there is one in Norway (PD). In Russia, the Bureau of Medical-Social Expertise is responsible for evaluation and granting of DP. In Norway, the local social insurance offices (SIO) are responsible for the DP application. Decisions are taken collectively in Russia, while the Norwegian PD and SIO officer often take decisions alone. In Russia, the medical criterion is the decisive one, while rehabilitation and treatment criteria are given priority in Norway. The size of the DP in Norway is enough to cover of subsistences expenditure, while the Russian DP is less than the level required for minimum subsistence. CONCLUSION: There were noteworthy differences in the time frame, organisation model and process leading to a DP in the two countries. These differences may explain why so few patients with less severe mental disorders receive a DP in Russia. This fact, in combination with the size of the DP, may hamper reforms of the mental health care system in Russia. BioMed Central 2007-08-16 /pmc/articles/PMC1994164/ /pubmed/17705818 http://dx.doi.org/10.1186/1472-6963-7-128 Text en Copyright © 2007 Rezvyy et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Rezvyy, Grigory
Schönfelder, Walter
Øiesvold, Terje
Olstad, Reidun
Midré, Georges
Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia
title Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia
title_full Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia
title_fullStr Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia
title_full_unstemmed Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia
title_short Between health care and social security – psychiatric patients and the disability pension system in Norway and Russia
title_sort between health care and social security – psychiatric patients and the disability pension system in norway and russia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994164/
https://www.ncbi.nlm.nih.gov/pubmed/17705818
http://dx.doi.org/10.1186/1472-6963-7-128
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