Sickness

-

English
200 pages
Obtenez un accès à la bibliothèque pour le consulter en ligne
En savoir plus

Informations

Publié par
Nombre de lectures 26
Langue English
Poids de l'ouvrage 3 Mo
Signaler un problème

eurostat
DIGEST OF STATISTICS
ON SOCIAL PROTECTION
IN EUROPE
Volume 5: Sickness
r
J-eurosta
STATISTISCHES AMT DER EUROPAISCHEN GEMEINSCHAFTEN
STATISTICAL OFFICE OF THE EUROPEAN COMMUNITIES
OFFICE STATISTIQUE DES COMMUNAUTÉS EUROPÉENNES
L-2920 Luxembourg — Tél. (352) 43 01-1 — Télex COMEUR LU 3423
B-1049 Bruxelles, rue de la Loi 200 — Tél. (32-2) 299 11 11
Eurostat hat die Aufgabe, den Informa­ It is Eurostat's responsibility to use the Pour établir, évaluer ou apprécier les dif­
tionsbedarf der Kommission und aller am European statistical system to meet the férentes politiques communautaires, la
Aufbau des Binnenmarktes Beteiligten requirements of the Commission and all Commission européenne a besoin d'infor­
mit Hilfe des europäischen statistischen parties involved in the development of the mations.
Systems zu decken. single market.
Eurostat a pour mission, à travers le sys­
To ensure that the vast quantity of ac­ tème statistique européen, de répondre Um der Öffentlichkeit die große Menge an
cessible data is made widely available, aux besoins de la Commission et de l'en­verfügbaren Daten zugänglich zu machen
and to help each user make proper use of und Bonutzern die Orientierung zu semble des personnes impliquées dans
this information, Eurostat has set up two erleichtern, werden zwei Arten von Publi­ le développement du marché unique.
main categories of document: statistical kationen angeboten: Statistische Doku­
documents and publications. mente und Veröffentlichungen. Pour mettre à la disposition de tous l'im­
portante quantité de données accessibles
The statistical document is aimed at spe­
Statistische Dokumente sind für den et faire en sorte que chacun puisse
cialists and provides the most complete
Fachmann konzipiert und enthalten das s'orienter correctement dans cet ensem­
sets of data: reference data where the
ausführliche Datenmaterial: Bezugs­ ble, deux grandes catégories de docu­
methodology is well-established, stand­
ments ont été créées: les documents daten, bei denen die Konzepte allgemein
ardized, uniform and scientific. These
statistiques et les publications. bekannt, standardisiert und wissenschaft­
data are presented in great detail. The
lich fundiert sind. Diese Daten werden in
statistical document is intended for ex­
einer sehr tiefen Gliederung dargeboten. Le document statistique s'adresse aux
perts who are capable of using their own
Die Statistischen Dokumente wenden spécialistes. Il fournit les données les plus
means to seek out what they require. The
sich an Fachleute, die in der Lage sind, complètes: données de référence où la
information is provided on paper and/or
selbständig die benötigten Daten aus der méthodologie est bien connue, standar­
on diskette, magnetictape, CD-ROM. The
Fülle des dargebotenen Materials auszu­ disée, normalisée et scientifique. Ces
white cover sheet bears a stylized motif
wählen. Diese Daten sind in gedruckter données sont présentées à un niveau très
which distinguishes the statistical docu­
Form und/oder auf Diskette, Magnet­ détaillé. Le document statistique est des­
ment from other publications.
band, CD-ROM verfügbar. Statistische tiné aux experts capables de rechercher,
Dokumente unterscheiden sich auch par leurs propres moyens, les données
The publications proper tend to be com­
optisch von anderen Veröffentlichungen requises. Les informations sont alors
piled for a well-defined and targeted
durch den mit einer stilisierten Graphik disponibles sur papier et/ou sur disquette,
public, such as educational circles or
versehenen weißen Einband. bande magnétique, CD-ROM. La couver­
political and administrative decision­
ture blanche ornée d'un graphisme stylisé
makers. The information in these docu­
démarque le document statistique des Veröffentlichungen wenden sich an eine ments is selected, sorted and annotated
autres publications. ganz bestimmte Zielgruppe, wie zum to suit the target public. In this instance,
Beispiel an den Bildungsbereich oder an therefore, Eurostat works in an advisory
Entscheidungsträger in Politik und Ver­ Les publications proprement dites peu­capacity.
waltung. Sie enthalten ausgewählte und vent, elles, être réalisées pour un public
Where the readership is wider and less bien déterminé, ciblé, par exemple auf die Bedürfnisse einer Zielgruppe
well-defined, Eurostat provides the infor­ l'enseignement ou les décideurs politi­abgestellte und kommentierte Informa­
mation required for an initial analysis, ques ou administratifs. Des informations tionen. Eurostat übernimmt hier also eine
sélectionnées, triées et commentées en such as yearbooks and periodicals which Art Beraterrolle.
fonction de ce public lui sont apportées. contain data permitting more in-depth
Eurostat joue, dès lors, le rôle de conseil­Für einen breiteren Benutzerkreis gibt studies. These publications are available
ler. Eurostat Jahrbücher und periodische on paper or in videotext databases.
Veröffentlichungen heraus. Diese enthal­
To help the user focus his research, ten statistische Ergebnisse für eine erste Dans le cas d'un public plus large, moins
Eurostat has created 'themes', i.e. subject Analyse sowie Hinweise auf weiteres défini, Eurostat procure des éléments
classifications. The statistical documents Datenmaterial für vertiefende Unter­ nécessaires à une première analyse, les
and publications are listed by series: e.g. suchungen. Diese Veröffentlichungen annuaires et les périodiques, dans les­
yearbooks, short-term trends or method­werden in gedruckter Form und in Daten­ quels figurent les renseignements adé­
ology in order to facilitate access to the banken angeboten, die in Menütechnik quats pour approfondir l'étude. Ces
statistical data. zugänglich sind. publications sont présentées sur papier
ou dans des banques de données de type
Y. Franchet
vidéotex. Um Benutzern die Datensuche zu erleich­
Director-General
tern, hat Eurostat Themenkreise, d. h.
eine Untergliederung nach Sachgebieten, Pour aider l'utilisateur à s'orienter dans
ses recherches, Eurostat a créé les eingeführt. Daneben sind sowohl die
thèmes, c'est-à-dire une classification Statistischen Dokumente als auch die
Veröffentlichungen in bestimmte Reihen, par sujet. Les documents statistiques et
wie zum Beispiel „Jahrbücher", „Kon­ les publications sont répertoriés par
junktur", „Methoden", untergliedert, um série — par exemple, annuaire, conjonc­
den Zugriff auf die statistischen Informa­ ture, méthodologie — afin de faciliter
tionen zu erleichtern. l'accès aux informations statistiques.
Y. Franchet Y. Franchet
Generaldirektor Directeur général DIGEST OF STATISTICS
ON SOCIAL PROTECTION
IN EUROPE
Volume 5: Sickness
Theme
Population and social conditions
Series
Studies and research
STATISTICAL DOCUMENT Cataloguing data can be found at the end of this publication.
Luxembourg: Office for Official Publications of the European Communities, 1995
ISBN 92-826-8239-0
© ECSC-EC-EAEC, Brussels · Luxembourg, 1995
Reproduction is authorized, except for commercial purposes, provided the source is acknowledged.
Printed in Italy
Printed on non-chlorine bleached paper CONTENTS
Part I INTRODUCTION
1. Objectives 6
2. Classifications
3. Method used to compile the Digest 7
4. Presentation of data
5.1 Sickness function: Content
5.2s: Definitions of types of benefit
6. Other statistics on health care 8
Part II COUNTRY TABLES: Benefit expenditure
Belgium 14
Denmark8
Germany 20
Greece2
Spain
France7
Ireland 3
Italy3
Luxembourg5
Netherlands
Portugal 41
United Kingdom4
Part III ANALYSIS AND COMPARATIVE TABLES
0. Remarks on the comparability of the data 50
1. Trends in benefit expenditure
2. Per-capitate
3. Benefit expenditure and GDP2
4. Breakdown by type of benefit3
4.1 Breakdown by group of schemes
4.2n by benefits in cash and in kind
4.3n by type of benefits in kind4
4.4 Breakdown by type ofs in cash
5. Proposed future work 55
6. Summary tables
6.1 Amounts of benefits by type - 19916
6.2 Trends of benefit amounts in national currencies at 1985 prices 57
6.3 Benefit amounts as a percentage of GDP and per capita - 19809
6.4ts as ae of GDP and per capita - 1991 60
Part IV DESCRIPTIVE FORMS BY TYPE OF BENEFIT
Belgium 62
Denmark 87
Germany 95
Greece 10
Spain8
France 121
Ireland
Italy 140
Luxembourg
Netherlands 156
Portugal 16
United Kingdom 18
ANNEX
Review of the main methodological differences between the study of the Sickness function by Eurostat and the
OECD health accounts 19
3 This study was carried out for EUROSTAT by Françoise Duchesne.
Eurostat would like to thank the Working Party on Social Protection Statistics and the representatives of the Member States
who have collaborated in compiling this publication. Part I INTRODUCTION At regular intervals Eurostat publishes aggregate data on c) They are classified in three groups of schemes:
current social protection expenditure and receipts , which - Basic scheme
are compiled and presented using the European ESSPROS - Supplementary schemes
methodology . One classification of the benefits is by - Means-tested welfare schemes
"functions", in other words by risk, eventuality or need
covered. These correspond to the ESSPROS groups of schemes.
The Digest of Statistics on Social Protection in Europe - As a reminder, and without repeating the full definitions in
the methodology, the basic schemes (paragraph 317) are of which this paper will represent Volume V devoted to the
Sickness function - provides more detailed data on the schemes which, pursuant to laws or regulations, provide for
primary protection against one or more risks. amounts paid out.
The supplementary schemes, known as complementary or 1. Objectives
supplementary in the ESSPROS methodology (paragraph
326), are schemes which presuppose that, in the case in The object of the Digest of Statistics on Social Protection
question, primary benefits are being granted under a basic in Europe is to obtain, in respect of each function, a
scheme. breakdown by type of benefit paid and the corresponding
numbers of beneficiaries. However, in view of the
The means-tested welfare schemes are known as "schemes difficulties encountered in collecting comparable data on
relating to other forms of social protection" in the beneficiaries in the Sickness function, Eurostat decided to
ESSPROS methodology (paragraph 329). Only benefits delay publication of this volume. A specific study is to
specifically intended for sick persons, e.g. medical aid made of it later.
provided by local authorities to persons who are sick and
indigent. When these payments are made as a last resort in This breakdown by type of benefit, specific to each
accordance with rules which apply to the entire function and identical for all Member States, should enable
population,they are classified under the Poverty function·^). more precise comparisons at European level (cf. Part III)
and more detailed analyses at country level (cf. Part II) to
In the ESSPROS (paragraph 316) the first two groups of be undertaken concurrently, and the two approaches to be
schemes are subdivided into national, general, special combined.
(further subdivided) and voluntary schemes. So as not to
overburden the tables, and since the Digest is not meant to The fact sheets which describe the main features of national
give an institutional analysis of the schemes, these benefits (cf. Part IV) for a given function - i.e. the agency
subdivisions have not been included here.
which procures the benefits, the conditions governing
eligibility and the method of calculating them - should be of
d) Since the types of benefits considered in this Digest are great assistance in interpreting the data.
specific to each function, they differ from the types of
benefits in the ESSPROS (paragraph 605), which are Lastly, the collecting of data at two different levels, i.e. the
common to all the functions and therefore more genera! "agencies" or administrative units in the case of ordinary
(see classification plan further on). ESSPROS statistics, and at the level of national benefits in
the case of data in the Digest, enables validity checks to be
This change reflects the attempt to obtain uniform made by crosschecking.
classifications for all countries in the most appropriate way
for providing an analysis by function from one country to
2. Classifications
another. The "types" in the Digest and in the ESSPROS
differ therefore not in concept but in the level at which the (4).
ESSPROS classifies social protection benefits as follows
benefits enjoyed by the household are presented. These
types are generic e.g., daily allowances, dental care, etc.,
- by country
and combine national benefits covering the same risks
- by function (or social risk)
under a law or a specific regulation: e.g. in Belgium, in the
- by scheme (or grouping of administrative units referred to
case of the daily allowances paid by the social security
as agencies)
institution under the basic schemes, allowances paid to
- by type of benefit (general types, identical for all
statutory agents of the Belgian Railways (SNCB) and to
functions).
employees of the Merchant Navy (RTM).
The classification and presentation of statistical results in
the Digest are based on this ESSPROS classification,
The various types of benefits and their definitions are listed
subject to the following clarifications.
in point 5.2 of this introduction. The national types of
a) Each volume of the Digest contains data for one of the
benefits are given in the descriptive forms (Part IV).
twelve functions. Volume V covers sickness as defined in
point 5.1 of this introduction (only the expenditure amounts
It can be concluded from the above that the Digest uses the
are given in this volume).
ESSPROS methodology but groups the benefits differently
b) The data are presented by country (Part II), and
under the various schemes and types.
summarized in the comparative tables (Part III). individual, affecting his physical or mental health in 3. Method used to compile the Digest
general.
Eurostat requested an expert from each country to supply,
This function includes: in respect of each function for the period 1980-1991,
detailed data regarding the amounts of benefits paid and the
a. wage/salary payment and allowances intended as total numbers of beneficiaries, accompanied by the relevant
or partial compensation for the loss of income descriptive forms.
resulting from the suspension of an occupation
because of sickness; From an analysis of this raw material, Eurostat compiled an
initial classification of types of benefits common to all the
b. payments to compensate for, or in addition to the countries. The national types ofs were then broken
above benefits; down in accordance with this classification. The
breakdowns of data were revised and the data and
c. payments to all protected persons equivalent to all or descriptive forms were supplemented.
part of the cost of medical care'8' of a preventive or
therapeutic nature; with regard to prevention, the main This work was carried out in close cooperation with the
areas covered are medical check-ups, vaccination Member States. The link with the ESSPROS data was
campaigns, health education, preventive measures etc. maintained throughout the project. As a result of this work,
some corrections will be made to the ESSPROS data.
d. expenditure of public health services, insofar as it
relates to allowances or medical care; The present volume has undoubtedly benefited from the
experience gained in producing Volumes 1-4, dealing with
e. other forms of social assistance for sick persons. the Old age, Invalidity/Disability, Survivors and Family
functions, which have already been published.
The following are excluded:
They are to be updated and improved at a later date. The
a. medical care given to an individual or a disabled volumes on the other functions are in preparation.
person (handicapped person, etc.) as specific treatment
for their invalidity or disability, i.e. in direct relation to
4. Presentation of data
the particular condition of the person concerned '9';
This introduction, containing definitions of the Sickness
b. medical care given to victims of occupational
function and the types of benefits specific to it, is followed
accidents or workers suffering froml
by country tables for the period 1980-1991 <6>(Part II).
illnesses, insofar as this care is directly related to the
These tables give the amounts of the benefits expressed in
injury or diseases in question'10';
national currency.
c. pre-natal, obstetrical and post-natal medical care'"';
Part III contains an analysis of the data on the basis of
comparative tables. This part of the publication gives an
d. medical care given to conscripted military personnel
overview of the trends in, and structure of, expenditure on
during their compulsory military service ',2';
the Sickness function in the European Union and in each of
the Member States.
e. any payments made to supplement allowances granted
on account of family responsibilities '13'.
Part IV contains descriptive forms giving the main
characteristics of national types of benefit for the Sickness
5.2. Sickness function: Definitions of types function. It shows the agency which procures the benefits,
the conditions for eligibility'7' and the method of of benefits
calculating the benefits.
11. Continued payment of wage or salary: benefit
To facilitate comparisons of the structures, the tables list all paid to the beneficiary while not working because of
the types of benefit, even if no data are available. A colon sickness, and equal to full earnings. It is paid either
":" indicates that the data are not available and a hyphen "-" by the employer or by the social security institution
indicates that they do not exist in the Member State in (other than the employer).
question.
A. Continued payment of wage or salary by
It must be emphasized that the data for the Federal employer
Republic of Germany refer to the situation prior to 3 B. Continued payment of wage or salary by social
October 1990. Statistics on the former GDR are not yet security institution.
available.
12. Sickness allowances: payment, as a flat rate or a
proportion of earnings, to offset partly earned 5.1. Sickness function: Content
income lost following interruption of activity
because of sickness. It is paid either by the "Sickness" must be understood in the strict sense as a
more or less deep-seated alteration in the health of the employer or by the social security institution (other devices and other medical prostheses supplied to
than the employer). out-patients.
A. Sickness allowances paid by employer
B.ss paid by social security 26. Laboratory tests and other examinations:
institution. laboratory tests, radiology and various other
examinations provided for out-patients other than
13. Other cash benefits: Benefits received by those provided during a stay in hospital or for
beneficiaries, for reasons linked to their state of preventive purposes.
health, which cannot be classified under the above
headings. 27. Prevention: systematic and collective check-ups and
preventive screening, including those conducted at
21. In-patient care: accomodation and therapeutic work and school; does not include benefits which
medical care supplied by medical and paramedical are not explicitly for preventive purposes.
hospital staff to patients during their stay in l (at least one night). This heading comprises 28. Other benefits in kind: benefits which cannot be
the supply of medicines, medical products and classified under one of the above headings; these
protheses, laboratory tests and other examinations include in particular transportation of sick persons
during hospitalization, but does not comprise (by ambulance treatmetc), periods of convalescence
prevention. or courses of ent.
22. Out-patient care: therapeutic care supplied by 6. Other statistics on the value of benefits in
medical or paramedical personnel, except for care kind
supplied during a stay in a hospital (at least one
night) or care to be classified separately under other
For several years the OECD has published data on health
headings (see below). It comprises out-patient care
care. The basis of the OECD health accounts statistics
given by hospital, nursing home (not predominantly
differs from that of the present study on the Sickness
medical), doctors' surgeries or at home.
function. The OECD and Eurostat have specific objectives
in their approach to this branch. In order to avoid
23. Pharmaceutical products: pharmaceutical products confusion or over-hasty comparisons of the statistics, a
prescribed or supplied directly to out-patients. review of the main methodological differences between
the two international organizations is provided in an annex
24. Dental care: dental treatment, provision of dental to this publication.
products and prostheses, to out-patients.
25. Medical prostheses: optical appliances (spectacles,
contact lenses, etc.) hearing aids, orthopaedic
Notes
Cf. statistical document "Social protection expenditure and receipts, 1980-1992". (1)
The expenditure comprises mainly social protection benefits and the agencies' operating costs. (2)
European System of Integrated Social Protection Statistics. (3)
Eurostat - "European System of Integrated Social Protection Statistics (Esspros), Methodology - Part I, 1981". (4)
Highlighting benefits which guarantee adequate resources to sick people but which are not peculiar to them, and (5)
classifying these benefits under the Sickness function, would reduce the usefulness of the General neediness
function, which is designed to provide a comparable measure of efforts to reduce poverty.
For Belgium and Greece the time series stops at 1990. (6)
The conditions of entitlement to the benefits fall into four main categories, viz: qualifying period, waiting period, (7)
(maximum) duration of benefit, and any other conditions.
- Qualifying period: minimum statutory period of employment, coverage or contributions, that the applicant must
fulfil in order to qualify for the benefit.
- Waiting period: period during which benefits are not granted following the occurence of the event covered by
the benefit. There is often a waiting period for benefits in cash, but hardly ever for benefits in kind.
Duration of benefit: maximum period during which the benefit is granted to the beneficiary. In the case of cash
benefits under the Sickness function, the period of payment ends when the insured person recovers his earning
capacity, is declared to be an invalid (permanent invalidity) or dies.
- Other conditions of entitlement.
Medical care includes the following goods and services: (8)
services provided by doctors (general practitioner or a specialist) or other medical personnel, within or outside
establishment (in out-patients department, surgeries, and home);
stays in hospital: medical treatment and maintenance;
dental care;