The Experts below are selected from a list of 5052 Experts worldwide ranked by ideXlab platform
Christian Ståhl - One of the best experts on this subject based on the ideXlab platform.
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Social Insurance literacy: a scoping review on how to define and measure it.
Disability and Rehabilitation, 2019Co-Authors: Christian Ståhl, Elin Karlsson, Jan Sandqvist, Gunnel Hensing, Sandra Brouwer, Emilie Friberg, Ellen MaceachenAbstract:Purpose: Sickness Insurance and workers’ compensation systems decide on peoples’ eligibility for benefits, and are commonly based on medical certificates and assessments of work ability. Systems di...
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Communication characteristics between clients and stakeholders within the Swedish Sickness Insurance system - a document analysis of granted and withdrawn Sickness benefit claims.
Disability and Rehabilitation, 2019Co-Authors: Elin Karlsson, Ida Seing, Jan Sandqvist, Christian StåhlAbstract:Purpose The purpose of this study was to investigate how communication within the Swedish Sickness Insurance system differs between cases of sick leave and how this may affect clients' cases. Materials and methods This was a document study using 30 client files from the Swedish Social Insurance Agency (SIA). The clients included had been on a work ability evaluation during their sick leave spell and were aged 32-64 years. The material was analyzed using qualitative document analysis. Results The results show different approaches to communication, characterized by emotional argumentation, matter-of-fact driven argumentation and information exchange, which have diverse success in affecting official decisions. Arguments characterized by emotions such as frustration or desperation are to a larger extent neglected by the authorities compared to those characterized by a matter-of-fact driven approach and referring to regulations and medical certificates. Conclusion There are differences regarding how clients and stakeholders communicate the clients' needs and pre-requisites, and how this affects official decisions. Further research must be carried out in order to establish social Insurance literacy, initially for individuals on sick leave within the Sickness Insurance system, and whether there are differences between diverse groups that could lead to injustices. Implications for rehabilitation Within a social Insurance context, professionals need to provide clients with adequate and individually adapted information in order for procedures to be perceived as comprehensible and manageable by the clients. The support from stakeholders such as the treating physician and/or employer can affect clients' sick-leave process. Clients' treating medical professionals can contribute to ensuring that clients rights are met by communicating the clients' needs to other stakeholders in a formal way.
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Reforming Activation in Swedish Work Disability Policy
The Science and Politics of Work Disability Prevention, 2018Co-Authors: Christian Ståhl, Ida SeingAbstract:In this chapter, we review the development of the activation concept in Swedish Sickness Insurance during the 2000s, by analyzing how it is conceptualized in government reports and translated into ...
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Shifting to Value-Based Principles in Sickness Insurance: Challenges in Changing Roles and Culture
Journal of Occupational Rehabilitation, 2018Co-Authors: Christian Ståhl, Frieda AnderssonAbstract:Purpose Management principles in Insurance agencies influence how benefits are administered, and how return to work processes for clients are managed and supported. This study analyses a change in managerial principles within the Swedish Sickness Insurance Agency, and how this has influenced the role of Insurance officials in relation to discretion and accountability, and their relationship to clients. Methods The study is based on a qualitative approach comprising 57 interviews with officials and managers in four Insurance offices. Results The reforms have led to a change in how public and professional accountability is defined, where the focus is shifted from routines and performance measurements toward professional discretion and the quality of encounters. However, the results show how these changes are interpreted differently across different layers of the organization, where New Public Management principles prevail in how line managers give feedback on and reward the work of officials. Conclusions The study illustrates how the introduction of new principles to promote officials’ discretion does not easily bypass longstanding management strategies, in this case managing accountability through top-down performance measures. The study points out the importance for public organizations to reconcile new organizational principles with the current organizational culture and how this is manifested through managerial styles, which may be resistant to change. Promoting client-oriented and value-driven approaches in client work hence needs to acknowledge the importance of organizational culture, and to secure that changes are reflected in organizational procedures and routines.
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Fair or square? Experiences of introducing a new method for assessing general work ability in a Sickness Insurance context.
Disability and Rehabilitation, 2017Co-Authors: Christian Ståhl, Ida Seing, Björn Gerdle, Jan SandqvistAbstract:PURPOSE To study social validity and perceived fairness of a new method for assessing general work ability in a Sickness Insurance context. Assessments are based on self-reports, combined with examinations by physicians, and, if needed, occupational therapists, physiotherapists and/or psychologists. MATERIALS AND METHODS Interviews with 36 Insurance officials, 10 physicians, and 36 sick-listed persons, which were analysed through a qualitative content analysis. RESULTS Insurance officials and physicians considered the method useful and that it facilitated benefit decisions. The experiences of persons who had undergone the assessment differed, where the dialog with Insurance officials seemed to have had an influence on experiences of the assessment and the decisions it led to. CONCLUSIONS The perceived fairness and social validity of the assessment depended on how it was carried out; organisational conditions and priorities; communication skills; and decision outcomes. Professionals have an important pedagogical task in explaining the purpose and procedure of the assessment in order for the sick-listed to perceive it as fair rather than square, i.e., too standardised and not considering individual conditions. If the assessment could be used also for rehabilitative purposes, it could possibly be perceived as more acceptable also in cases where it leads to denied benefits. Implications for rehabilitation The perceived fairness of work ability assessments is dependent on procedures for the assessment, communication with the person, and the outcome. What is considered fair differs between assessing professionals and persons being assessed. Professionals may influence the perceptions of fairness through their way of communication. Assessments need to be coupled with rehabilitation measures in order to perceived as relevant and acceptable.
Kerstin Ekberg - One of the best experts on this subject based on the ideXlab platform.
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Swedish rehabilitation professionals' perspectives on work ability assessments in a changing Sickness Insurance system.
Disability and Rehabilitation, 2011Co-Authors: Christian Ståhl, Tommy Svensson, Gunilla Petersson, Kerstin EkbergAbstract:Purpose: This article analyses Swedish rehabilitation professionals’ perspectives on how changed Sickness Insurance regulations will affect their practice and cooperation, with a special focus on w ...
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From Cooperation to Conflict? Swedish Rehabilitation Professionals’ Experiences of Interorganizational Cooperation
Journal of Occupational Rehabilitation, 2011Co-Authors: Christian Ståhl, Tommy Svensson, Kerstin EkbergAbstract:Purpose This article analyses Swedish rehabilitation professionals’ experiences of interorganizational cooperation in return-to-work and labour market reintegration. Method Two groups (n = 15) from different organizations met on a regular basis to discuss their practice from a cooperation perspective. The participants had experience of cooperation in the organizational setting of Coordination Associations. The groups worked with a tutor according to a problem-based methodology, to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis. Results Interorganizational cooperation in rehabilitation is generally perceived as promoting coherence and communication. Nevertheless, there are several contradictory factors in the implementation of such work forms, primarily inflexible Sickness Insurance regulations and inability of managers to implement cooperation in regular practice. Conclusions While interorganizational cooperation promotes professional discretion and tailored solutions, the Insurance system contradicts such ambitions through increased governance. Ultimately, the contradictory tendencies of cooperative initiatives and the stricter governance of Sickness Insurance regulations are political matters. If political attempts to promote interorganizational cooperation are to succeed, the increasing sectorization that results from strict governance of Sickness Insurance regulations needs to be targeted on a system level.
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Swedish Rehabilitation Professionals' Perspectives on Work Ability Assessments in a Changing Sickness Insurance System
2010Co-Authors: Christian Ståhl, Tommy Svensson, Gunilla Petersson, Kerstin EkbergAbstract:Swedish Rehabilitation Professionals' Perspectives on Work Ability Assessments in a Changing Sickness Insurance System
Jan Sandqvist - One of the best experts on this subject based on the ideXlab platform.
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Social Insurance literacy: a scoping review on how to define and measure it.
Disability and Rehabilitation, 2019Co-Authors: Christian Ståhl, Elin Karlsson, Jan Sandqvist, Gunnel Hensing, Sandra Brouwer, Emilie Friberg, Ellen MaceachenAbstract:Purpose: Sickness Insurance and workers’ compensation systems decide on peoples’ eligibility for benefits, and are commonly based on medical certificates and assessments of work ability. Systems di...
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Communication characteristics between clients and stakeholders within the Swedish Sickness Insurance system - a document analysis of granted and withdrawn Sickness benefit claims.
Disability and Rehabilitation, 2019Co-Authors: Elin Karlsson, Ida Seing, Jan Sandqvist, Christian StåhlAbstract:Purpose The purpose of this study was to investigate how communication within the Swedish Sickness Insurance system differs between cases of sick leave and how this may affect clients' cases. Materials and methods This was a document study using 30 client files from the Swedish Social Insurance Agency (SIA). The clients included had been on a work ability evaluation during their sick leave spell and were aged 32-64 years. The material was analyzed using qualitative document analysis. Results The results show different approaches to communication, characterized by emotional argumentation, matter-of-fact driven argumentation and information exchange, which have diverse success in affecting official decisions. Arguments characterized by emotions such as frustration or desperation are to a larger extent neglected by the authorities compared to those characterized by a matter-of-fact driven approach and referring to regulations and medical certificates. Conclusion There are differences regarding how clients and stakeholders communicate the clients' needs and pre-requisites, and how this affects official decisions. Further research must be carried out in order to establish social Insurance literacy, initially for individuals on sick leave within the Sickness Insurance system, and whether there are differences between diverse groups that could lead to injustices. Implications for rehabilitation Within a social Insurance context, professionals need to provide clients with adequate and individually adapted information in order for procedures to be perceived as comprehensible and manageable by the clients. The support from stakeholders such as the treating physician and/or employer can affect clients' sick-leave process. Clients' treating medical professionals can contribute to ensuring that clients rights are met by communicating the clients' needs to other stakeholders in a formal way.
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initial evaluation of psychometric properties of a structured work task application for the assessment of work performance in a constructed environment
Disability and Rehabilitation, 2018Co-Authors: Elin Karlsson, Gunilla Liedberg, Jan SandqvistAbstract:Purpose: The Swedish Social Insurance Administration has developed a new assessment tool for Sickness Insurance. This study is a part of the initial evaluation of the application, called the Assess ...
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Fair or square? Experiences of introducing a new method for assessing general work ability in a Sickness Insurance context.
Disability and Rehabilitation, 2017Co-Authors: Christian Ståhl, Ida Seing, Björn Gerdle, Jan SandqvistAbstract:PURPOSE To study social validity and perceived fairness of a new method for assessing general work ability in a Sickness Insurance context. Assessments are based on self-reports, combined with examinations by physicians, and, if needed, occupational therapists, physiotherapists and/or psychologists. MATERIALS AND METHODS Interviews with 36 Insurance officials, 10 physicians, and 36 sick-listed persons, which were analysed through a qualitative content analysis. RESULTS Insurance officials and physicians considered the method useful and that it facilitated benefit decisions. The experiences of persons who had undergone the assessment differed, where the dialog with Insurance officials seemed to have had an influence on experiences of the assessment and the decisions it led to. CONCLUSIONS The perceived fairness and social validity of the assessment depended on how it was carried out; organisational conditions and priorities; communication skills; and decision outcomes. Professionals have an important pedagogical task in explaining the purpose and procedure of the assessment in order for the sick-listed to perceive it as fair rather than square, i.e., too standardised and not considering individual conditions. If the assessment could be used also for rehabilitative purposes, it could possibly be perceived as more acceptable also in cases where it leads to denied benefits. Implications for rehabilitation The perceived fairness of work ability assessments is dependent on procedures for the assessment, communication with the person, and the outcome. What is considered fair differs between assessing professionals and persons being assessed. Professionals may influence the perceptions of fairness through their way of communication. Assessments need to be coupled with rehabilitation measures in order to perceived as relevant and acceptable.
Tommy Svensson - One of the best experts on this subject based on the ideXlab platform.
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Implementation of standardized time limits in Sickness Insurance and return-to-work: experiences of four actors.
Disability and Rehabilitation, 2011Co-Authors: Christian Ståhl, Ulrika Müssener, Tommy SvenssonAbstract:Purpose: In 2008, time limits were introduced in Swedish Sickness Insurance, comprising a pre-defined schedule for return-to-work. The purpose of this study was to explore experienced consequences ...
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Swedish rehabilitation professionals' perspectives on work ability assessments in a changing Sickness Insurance system.
Disability and Rehabilitation, 2011Co-Authors: Christian Ståhl, Tommy Svensson, Gunilla Petersson, Kerstin EkbergAbstract:Purpose: This article analyses Swedish rehabilitation professionals’ perspectives on how changed Sickness Insurance regulations will affect their practice and cooperation, with a special focus on w ...
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From Cooperation to Conflict? Swedish Rehabilitation Professionals’ Experiences of Interorganizational Cooperation
Journal of Occupational Rehabilitation, 2011Co-Authors: Christian Ståhl, Tommy Svensson, Kerstin EkbergAbstract:Purpose This article analyses Swedish rehabilitation professionals’ experiences of interorganizational cooperation in return-to-work and labour market reintegration. Method Two groups (n = 15) from different organizations met on a regular basis to discuss their practice from a cooperation perspective. The participants had experience of cooperation in the organizational setting of Coordination Associations. The groups worked with a tutor according to a problem-based methodology, to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis. Results Interorganizational cooperation in rehabilitation is generally perceived as promoting coherence and communication. Nevertheless, there are several contradictory factors in the implementation of such work forms, primarily inflexible Sickness Insurance regulations and inability of managers to implement cooperation in regular practice. Conclusions While interorganizational cooperation promotes professional discretion and tailored solutions, the Insurance system contradicts such ambitions through increased governance. Ultimately, the contradictory tendencies of cooperative initiatives and the stricter governance of Sickness Insurance regulations are political matters. If political attempts to promote interorganizational cooperation are to succeed, the increasing sectorization that results from strict governance of Sickness Insurance regulations needs to be targeted on a system level.
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Swedish Rehabilitation Professionals' Perspectives on Work Ability Assessments in a Changing Sickness Insurance System
2010Co-Authors: Christian Ståhl, Tommy Svensson, Gunilla Petersson, Kerstin EkbergAbstract:Swedish Rehabilitation Professionals' Perspectives on Work Ability Assessments in a Changing Sickness Insurance System
Per Johansson - One of the best experts on this subject based on the ideXlab platform.
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Effects of eligibility screening in the Sickness Insurance: Evidence from a field experiment ☆
Labour Economics, 2013Co-Authors: Laura Hartman, Patrik Hesselius, Per JohanssonAbstract:We study the effects of screening stringency in the Swedish Sickness Insurance system by exploiting a field experiment. The experiment was conducted on 270,000 individuals in two geographical areas with the treatment group randomized by date of birth. The screening of eligibility was reduced for the treated by the postponement of the requirement for a doctor's certificate from day eight to day fifteen in a Sickness benefit spell. The results show that extending the waiting period increased the length of Sickness absence by on average 0.6days. The experiment increased Sickness benefit expenses but reduced the number of visits to a doctor. Our results show that postponing the requirement for a doctor's certificate increases public expenses for the Sickness Insurance system.
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effects of eligibility screening in the Sickness Insurance evidence from a field experiment
Labour Economics, 2013Co-Authors: Patrik Hesselius, Laura Hartman, Per JohanssonAbstract:We study the effects of screening stringency in the Swedish Sickness Insurance system by exploiting a field experiment. The experiment was conducted on 270,000 individuals in two geographical areas with the treatment group randomized by date of birth. The screening of eligibility was reduced for the treated by the postponement of the requirement for a doctor's certificate from day eight to day fifteen in a Sickness benefit spell. The results show that extending the waiting period increased the length of Sickness absence by on average 0.6days. The experiment increased Sickness benefit expenses but reduced the number of visits to a doctor. Our results show that postponing the requirement for a doctor's certificate increases public expenses for the Sickness Insurance system.
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Should Sickness Insurance and health care be administrated by the same jurisdiction? An empirical analysis
2012Co-Authors: Per Johansson, Martin NilssonAbstract:Sweden has obligatory Sickness and disability Insurance which is both financed (from payroll taxes) and administered by the government. In order to receive Sickness benefits, insured individuals must have certificates issued by a medical doctor. Since health care is administered at the county level, this means that monitoring is, to some extent, decentralized at a lower jurisdictional level than the funding and governance of the Insurance. This paper studies one consequence of such decentralization: the effect on individual Sickness absence when such certificates are not approved by the Sickness Insurance Agency (SIA)and are instead re-remitted to the doctor for completion and, potential, reapproval by the SIA. We find that this re-remission increases the length of Sickness absence spells by an average of 30 percent. A suggestive test of the reason for the observed effect indicates that it is due to a decrease in health caused by increased stress related to the uncertainty about entitlement and future Sickness benefits. Given that added resources improve the quality of the patients’ medical certificates, directed intergovernmental grants from the state to the counties would be cost saving.
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Monitoring and norms in Sickness Insurance: empirical evidence from a natural experiment
2008Co-Authors: Patrik Hesselius, Per Johansson, Johan VikströmAbstract:We test if social work norms are important for work absence due to self-perceived Sickness. To this end, we use a randomized social experiment designed to estimate the effect of monitoring on work absence. The treated were exposed to less monitoring of their eligibility to use Sickness Insurance, which increased their non-monitored work absence. Based on a difference in differences analysis, we find that the not directly treated also increased their absence as a result of the experiment. By using an instrumental variables estimator, we find significant endogenous social interaction effects. A 10 per cent exogenous shock in work absence would lead to an immediate 5.7 per cent decrease in the hazard out of Sickness absence: the long-run effect is calculated as a 13.3 per cent decrease in the corresponding hazard.
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Moral hazard and Sickness Insurance
Journal of Public Economics, 2005Co-Authors: Per Johansson, Mårten PalmeAbstract:We use a reform of Sweden’s Sickness Insurance system as a source of exogenous variation to analyse the presence of moral hazard. As a result of the reform, the replacement level was reduced from 90 percent of forgone earnings to 65 percent for the first three days; to 80 percent between day 4 and 90; and remained at 90 percent after 90 days. We find that the incidence of work absence decreased due to the decrease in compensation level and that effect on duration is in accordance with moral hazard in the Sickness Insurance. We estimate the elasticities of the incidence with respect to forgone earning to -1 for males and -0.70 for females.
