Læknablaðið - 01.12.2021, Blaðsíða 16

580 L ÆKNABL AÐIÐ 2021/107
R A N N S Ó K N
dómar eru langalgengustu sjúkdómsflokkar sem leiða til skertrar
starfsgetu. Heldur lægra hlutfall öryrkja er með geðgreiningu sem
fyrstu sjúkdómsgreiningu á tímabilinu 2000-2019 samanborið við
þá sem áttu gildandi örorkumat 2005 en hlutfall stoðkerfissjúk-
dóma er heldur hærra. Engu að síður skera geðsjúkdómar sig úr
hvað varðar aldursdreifingu og fjölgun eftir því sem nær dregur í
tíma. Ungt fólk sem verður óvinnufært af heilsufarsástæðum býr
við skert lífsgæði til frambúðar og samfélagslegur kostnaður er
hærri því yngra sem fólk er þegar það verður óvinnufært. Fleiri
og betri meðferðar- og endurhæfingarúrræði vegna geðsjúkdóma,
til dæmis innan heilsugæslunnar, munu væntanlega skila bættri
færni þessa hóps. Fleira þarf þó til ef sporna á við því að réttinda-
greiðslur TR vegna endurhæfingar- og örorkulífeyris haldi áfram
að vaxa sem hlutfall af ríkisútgjöldum.
Þakkir
Þökkum samstarfsfólki okkar á Tryggingastofnun yfirlestur og
ábendingar, Gísla Oddssyni lögfræðingi og Sigríði Lillý Baldurs-
dóttur forstjóra.
E N G L I S H S U M M A R Y
Ólafur Ó. Guðmundsson
Guðmundur Hjaltalín
Haukur Eggertsson
Þóra Jónsdóttir
The Social Insurance Administration.
Correspondence: Ólafur Ó. Guðmundsson, olafur.gudmundsson@tr.is
Key words: work capacity, rehabilitation, disability, medical certificate
Diagnosis, rehabilitation and development of disability 2000-2019 in Iceland
INTRODUCTION: The disability assessment standard based on medically recognized
illnesses or disabilities was introduced in Iceland 1999. The aim of this study is to examine
the development of Social Insurance Administration (Tryggingastofnun ríkisins, TR) rulings
regarding rehabilitation and disability pensions over a twenty-year period, since its
introduction.
MATERIAL AND METHODS: All registered diagnoses in the medical certificates of TR due
to the approved rehabilitation or disability pension were examined in the period 2000-
2019. The gender distribution and age distribution of these applicants and the number
development during the period are described. At the same time, costs as a percentage of
government expenditure are examined.
RESULTS: The number of younger rehabilitation pensioners has increased rapidly in
recent years, at the same time as the relative increase in disability pensioners has slowed
slightly. Mental and musculoskeletal disorders are by far the most common types of illness
leading to disability. Mental illnesses differ in terms of age distribution and increase over
time. The proportion of individuals aged 18-66 with a 75% disability assessment has
increased by a third during the period, from about 6% to 8%. The gender distribution of
disability pensioners remains similar, with women accounting for 62% in total. Women are
much more likely to receive disability pension due to musculoskeletal disorders than men
and men are somewhat more likely to suffer from mental illness. The relative development
of central government expenditure on total payments to rehabilitation and pensioners
continues to grow as a proportion of central government expenditure.
CONCLUSION: The number of rehabilitation pensioners has increased significantly since
2018, at the same time as the number of disability pensioners has decreased and there
are indications that rehabilitation results in a lower number of new disability pensioners.
Mental and musculoskeletal disorders are by far the most common types of illness leading
to disability. A slightly lower proportion of disabled people have psychiatric diagnosis
as a first diagnosis in the period 2000-2019 compared to those with a valid disability
assessment in 2005, but the proportion of musculoskeletal disorders is slightly higher.
Nevertheless, mental illnesses differ in age distribution and increase over time.
doi 10.17992/lbl.2021.12.664
Heimildir
1. Lög um almannatryggingar nr. 100. 2007.
2. Lög um persónuvernd og vinnslu persónuupplýsinga nr. 90. 2018.
3. Thorlacius S, Stefánsson SB, Jóhannsson H. Örorkumat fyrir og eftir gildistöku örorku-
matsstaðals. Læknablaðið 2001; 87: 721-3.
4. Lög um félagslega aðstoð nr. 99. 2007.
5. Reglugerð um framkvæmd endurhæfingarlífeyris samkvæmt lögum um félagslega aðstoð.
202.0
6. Herbertsson TÞ. Fjölgun öryrkja á Íslandi - Orsakir og afleiðingar. 2005. stjornarradid.is/
verkefni/fleiri-rit/rit/2005/05/10/Fjolgun-oryrkja-a-Islandi-Orsakir-og-afleidingar/ - maí
2021.
7. Thorlacius S, Stefánsson SB, Ólafsson S. Algengi örorku á Íslandi 1. desember 2005.
Læknablaðið 2007; 93: 11-4.
8. Nýtt greiðslukerfi vegna skertrar starfsgetu. Félagsmálaráðuneyti 2019. stjornarradid.is/
gogn/rit-og-skyrslur/stakt-rit/2019/05/10/Nytt-greidslukerfi-vegna-skertrar-starfsgetu/ -
maí 2021.
9. Endurhæfing - Tillögur að endurhæfingarstefnu. Heilbrigðisráðuneytið 2020.
stjornarradid.is/library/04-Raduneytin/Heilbrigdisraduneytid/ymsar-skrar/Endurhaefing-
tillogur-ad-stefnu_Sept2020.pdf - maí 2021.
10. Thorlacius S, Herbertsson TT. Hve lengi eru menn öryrkjar á Íslandi? Læknablaðið 2005;
91: 501-4.
11. Thorlacius S, Stefánsson SB, Ranavaya MI, et al. Vefjagigt og kvíðaröskun. Læknablaðið
2002; 88: 815-8.
12. Sálfræðiþjónusta. throunarmidstod.is/svid-thih/salfraedithjonusta/- maí 2021.
13. FPA:s förmåner för personer med funktionsnedsättning. 2019. helda.helsinki.fi/bitstream/
handle/10138/322909/3_KelanVammaisetuudet_Kelan_tilastollinen_vuosikirja_2019.pdf -
maí 2021.
14. Social Protection in the Nordic Countries. 2016. norden.diva-portal.org/smash/get/
diva2:1148493/FULLTEXT02.pdf - maí 2021.
Greinin barst til blaðsins 22. maí 2021,
samþykkt til birtingar 24. september 2021