Læknablaðið - 15.03.2001, Page 13

FRÆÐIGREINAR / ÖRORKA
Breytingar á algengi örorku
á íslandi 1976-1996
Sigurður
Thorlacius1'2,
Sigurjón
Stefánsson1,
Stefán Ólafsson3,
Vilhjálmur
Rafnsson2
'Tryggingastofnun ríkisins,
dæknadeild Háskóla íslands,
3félagsvísindadeild Háskóla
íslands. Fyrirspurnir,
bréfaskipti: Sigurður
Thorlacius, Tryggingastofnun
ríkisins, Laugavegi 114,150
Reykjavík. Sími: 560 4400;
bréfasími: 562 4146; netfang:
sigurdth@tr.is
Lykilorð: örorka, algengi
örorku, aldursstöðlun,
örorkubótaþegar,
almannatryggingar.
Ágrip
Tilgangur: Að kanna hvaða breytingar hafi orðið á
algengi örorku á fslandi og dreifingu öryrkja með
tilliti til kyns, aldurs og helstu sjúkdómsgreiningar á
milli áranna 1976 og 1996.
Efniviður og aðferðir: Unnar voru upplýsingar um
örorkumat, aldur og helstu sjúkdómsgreiningu
öryrkja úr örorkuskrá Tryggingastofnunar ríkisins,
eins og hún var 1. desember árin 1976 og 1996 og
aflað var upplýsinga um aldursdreifingu fslendinga
eftir kynjum á sama tíma. Reiknað var aldursstaðlað
áhættuhlutfall fyrir alla örorku og örorku sem var yfir
75% vegna nokkurra aðalsjúkdómsgreiningarflokka.
Niðurstöður: Ekki varð marktæk breyting á hrá
ENGU8H SUMMARY
Thoriacius S, Stefánsson S, Ólafsson S, Rafnsson V
Changes in the prevalence of disability pension in
lceland 1976-1996
Laeknablaðið 2001; 87: 205-9
Objective: To determine changes in the prevalence of
disability pension in lceland and to describe the
distribution of those receiving disability pension according
to gender, age and main diagnoses between the years
1976 and 1996.
Material and methods: The study includes all those
receiving disability pension on the 1st of December in the
years 1976 and 1996 as ascertained by the disability
register at the State Social Security Institute of lceland.
There are two levels of disability pension, full disability
pension (disability assessed as being more than 75%) and
reduced disability pension (disability assessed as being
50% or 65%). Information on age and gender distribution
of the lcelandic population was obtained. Age-
standardized risk ratio between the years 1976 and 1996
was calculated for both pension levels combined and for
full disability pension alone.
Results: There was no significant change in crude
prevalence rate for both pension levels combined between
the years 1976 and 1996, when the increase in the
population was accounted for but without paying attention
to changes in gender or age distribution. However, the
standardized risk ratio showed a significantly decreased
risk for both pension levels combined both for men and
women in the year 1996 as compared with the year 1976,
the age-standardized risk ratio being 0.95 and 0.93
respectiveiy. It also showed a significant change between
pension levels with an increased risk of full disability
pension and a decreased risk of reduced disability
pension. The increase in full disability pension was noted
for both males and females and was largely independent of
age. There was a significant increase in full disability
algengitölu fyrir alla örorku á milli áranna 1976 og
1996, að teknu tilliti til fólksfjölgunar en ekki
skiptingar eftir kynjum eða aldri. Hins vegar varð
innbyrðis breyting á örorkustigi, það er marktækt
fleiri höfðu verið metnir til örorku yfir 75% og
marktækt færri til 50% eða 65% örorku á árinu 1996
miðað við á árinu 1976. Aukningin á örorku yfir 75%
kom fram hjá báðum kynjunum og var í stórum
dráttum óháð aldri. Marktæk aukning varð hjá
báðum kynjum á örorku yfir 75% vegna flestra sjúk-
dómaflokka. Vegna sjúkdóma í taugakerfi og skyn-
færum og slysa og eitrana varð einungis marktæk
aukning á örorku hjá konum. Marktæk minnkun
pension in most disease categories. Disability due to
diseases of the nervous system and sense organs and
injury and poisoning increased amongst women only. A
significant decrease in full disability pension due to
infections and diseases of the digestive system occurred in
both men and women.
Conclusion: The prevalence of a disability pension
amongst men and women in the year 1996 as compared to
the year 1976 was significantly decreased when changes
in population size and age distribution had been
accounted for. This is particularly interesting because
unemployment was increasing just prior to the year 1996.
The prevalence of full disability pension had however
significantly increased in 1996 compared with 1976. A
piausible explanation for the observed change in disability
pension levels is a pressure from the labour market, with
increasing unemployment and competition. Also, the
introduction of a disability card for those with full disability
pension in 1980, which granted lower price for medication
and the services of physicians, is likely to have increased
the pressure for the higher level of disability pension (full
disability pension). It seems unlikely that the increase in full
disability pension and the decrease in reduced disability
pension is due to a deterioration of health of the lcelandic
population. Increased disability due to injury and poisoning
amongst women is probably a result of their increased
participation in the labour market. The decrease in
disability due to infections is a result of a reduction in the
number of cases of tuberculosis and poliomyelitis. The
decrease in disability due to diseases of the digestive
system is probably a result of improvement in the
treatment of oesophageal reflux and peptic ulcer.
Keywords: disability, prevalence of disability pension, age-
standardized, disability benefits, social security.
Correspondence: Sigurður Thorlacius. E-mail:
sigurdth@tr.is
Læknablaðið 2001/87 205