Kirsti Nurmela1, Virpi Heikkinen2, Risto Hokkanen3, Aarne Ylinen4, Jukka Uitti5, Aino Mattila6, Matti Joukamaa3, Pekka Virtanen7. 1. School of Health Sciences, University of Tampere, Tampere, Finland Department of Adult Psychiatry, Tampere University Hospital, Tampere, Finland Non-Institutional Mental Health Services, City of Tampere, Finland kirsti.nurmela@staff.uta.fi. 2. School of Health Sciences, University of Tampere, Tampere, Finland Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland. 3. School of Health Sciences, University of Tampere, Tampere, Finland. 4. Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland. 5. School of Health Sciences, University of Tampere, Tampere, Finland Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland Finnish Institute of Occupational Health, Tampere, Finland. 6. Department of Adult Psychiatry, Tampere University Hospital, Tampere, Finland. 7. School of Health Sciences, University of Tampere, Tampere, Finland Institute of advanced social research, University of Tampere, Tampere, Finland.
Abstract
AIMS: The aim of the study was to reveal potential gaps and inconsistencies in the identification of alcohol abuse in health care and in employment services and to analyse the granting of disability pensions with respect to the alcohol abuse identification pattern. METHODS: The material consisted of documentary information on 505 long-term unemployed subjects with low employability sent to the development project entitled 'Eligibility for a Disability Pension' in 2001-2006 in Finland. The dichotomous variables 'Alcohol abuse identified in employment services' and 'Alcohol abuse identified in health care' were cross-tabulated to obtain a four-class variable 'Alcohol abuse identification pattern'. Logistic regression analyses were conducted to ascertain the association of alcohol abuse identification pattern with the granting of disability pensions. RESULTS: Alcohol abuse was detected by both health care and employment services in 47% of those identified as abusers (41% of examinees). Each service systems also identified cases that the other did not. When alcohol abuse was identified in health care only, the OR for a disability pension being granted was 2.8 (95% CI 1.5-5.2) compared with applicants without identified alcohol abuse. The result remained the same and statistically significant after adjusting for confounders. CONCLUSIONS: Alcohol abuse identified in health care was positively associated with the granting of a disability pension. Closer co-operation between employment services and health care could help to identify those long-term unemployed individuals with impaired work ability in need of thorough medical examination.
AIMS: The aim of the study was to reveal potential gaps and inconsistencies in the identification of alcohol abuse in health care and in employment services and to analyse the granting of disability pensions with respect to the alcohol abuse identification pattern. METHODS: The material consisted of documentary information on 505 long-term unemployed subjects with low employability sent to the development project entitled 'Eligibility for a Disability Pension' in 2001-2006 in Finland. The dichotomous variables 'Alcohol abuse identified in employment services' and 'Alcohol abuse identified in health care' were cross-tabulated to obtain a four-class variable 'Alcohol abuse identification pattern'. Logistic regression analyses were conducted to ascertain the association of alcohol abuse identification pattern with the granting of disability pensions. RESULTS:Alcohol abuse was detected by both health care and employment services in 47% of those identified as abusers (41% of examinees). Each service systems also identified cases that the other did not. When alcohol abuse was identified in health care only, the OR for a disability pension being granted was 2.8 (95% CI 1.5-5.2) compared with applicants without identified alcohol abuse. The result remained the same and statistically significant after adjusting for confounders. CONCLUSIONS:Alcohol abuse identified in health care was positively associated with the granting of a disability pension. Closer co-operation between employment services and health care could help to identify those long-term unemployed individuals with impaired work ability in need of thorough medical examination.
Authors: Kirsti Nurmela; Aino Mattila; Virpi Heikkinen; Jukka Uitti; Aarne Ylinen; Pekka Virtanen Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2017-11-09 Impact factor: 4.328
Authors: Kirsti Nurmela; Aino Mattila; Virpi Heikkinen; Jukka Uitti; Aarne Ylinen; Pekka Virtanen Journal: Int J Environ Res Public Health Date: 2018-05-03 Impact factor: 3.390