Inequities in occupational diseases recognition in France.
Ethics
Indemnisation des accidentés du travail
Maladies professionnelles
Occupational diseases
Process Assessment (Health Care)
Workers’ Compensation
Éthique
Évaluation de processus en soins de santé
Journal
Revue d'epidemiologie et de sante publique
ISSN: 0398-7620
Titre abrégé: Rev Epidemiol Sante Publique
Pays: France
ID NLM: 7608039
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
13
02
2019
revised:
14
04
2019
accepted:
23
04
2019
pubmed:
27
6
2019
medline:
16
1
2020
entrez:
26
6
2019
Statut:
ppublish
Résumé
In France, complex cases of occupational disease (OD) are submitted to regional committees who are in charge of accepting, or rejecting, the claim. Their mean annual acceptance rate varies from one region to another, which may reflect differences in the cases, or discrepancies between committees. The objective of this study was to assess the comparability of the decisions of the committees on the basis of standardized cases. Three experienced occupational physicians specialized in OD were asked to develop 28 clinical cases representative of claims for compensation usually seen in these committees. The cases, in the form of short vignettes, were submitted to the 18 French regional committees, asking if they would recognise each case as an OD. All committees participated. The acceptance rate (recognition of the case as an OD) varied, ranging from 18% to 70%. All the committees took the same decision for only 7 out of the 28 cases, but half accepted and half refused for 3 cases. For 10 cases, one quarter of the committees gave a decision different than the other 75%. The highest discordance rates were observed for the cases concerning musculoskeletal disorders and asbestos related diseases. The committees take very different decisions in terms of recognition of OD, especially for the most frequently compensated OD in France, i.e. musculoskeletal disorders and asbestos related diseases. This is a major source of injustice for the employees who seek compensation and there is a need to develop methods to harmonize decisions between committees.
Sections du résumé
BACKGROUND
BACKGROUND
In France, complex cases of occupational disease (OD) are submitted to regional committees who are in charge of accepting, or rejecting, the claim. Their mean annual acceptance rate varies from one region to another, which may reflect differences in the cases, or discrepancies between committees. The objective of this study was to assess the comparability of the decisions of the committees on the basis of standardized cases.
METHODS
METHODS
Three experienced occupational physicians specialized in OD were asked to develop 28 clinical cases representative of claims for compensation usually seen in these committees. The cases, in the form of short vignettes, were submitted to the 18 French regional committees, asking if they would recognise each case as an OD.
RESULTS
RESULTS
All committees participated. The acceptance rate (recognition of the case as an OD) varied, ranging from 18% to 70%. All the committees took the same decision for only 7 out of the 28 cases, but half accepted and half refused for 3 cases. For 10 cases, one quarter of the committees gave a decision different than the other 75%. The highest discordance rates were observed for the cases concerning musculoskeletal disorders and asbestos related diseases.
CONCLUSION
CONCLUSIONS
The committees take very different decisions in terms of recognition of OD, especially for the most frequently compensated OD in France, i.e. musculoskeletal disorders and asbestos related diseases. This is a major source of injustice for the employees who seek compensation and there is a need to develop methods to harmonize decisions between committees.
Identifiants
pubmed: 31235191
pii: S0398-7620(19)30411-0
doi: 10.1016/j.respe.2019.04.054
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
247-252Informations de copyright
Copyright © 2019. Published by Elsevier Masson SAS.