Resumen

VICENTE PARDO, José Manuel. Reflection on problems return to work after long medical disabilities. Med. segur. trab. [online]. 2016, vol.62, n.242, pp.49-65. ISSN 1989-7790.

Lumbar diseases, psychiatric disorders and breast cancer are the three main cause's long-term medical disability. The long medical disabilities involve above all high costs in "human capital" and costs "health capital" worker serious consequences; it is a public health issue with an enormous impact on the economic system and benefit the public health system and social security benefits. It is urgent the development of a map of Disability in Spain, to meet risk population, risk markers, risk factors and evolution of long-term medical disabilities, and know evolution the protected own risk. If we know the crippling impact of the loss of health in the working population will proceed to better management and adaptation of public resources for care, health promotion, prevention, reintegration and services around the temporary and permanent disability. Among the risks of prolonged medical disabilities are the risk of job loss, increased risk of permanent disability, decreased quality of life, health risks, deterioration of family life and relationship, spending in support of their situation, not public health expenditures and a precarious situation and conflict to return to work. The best prevention is to know why sick and the best social protection knows what we spend. To avoid the problems return to work after a long disability is necessary to know how many factors cause them, as well as personal, labour, social and demographic circumstances that modulate and the evolution of both temporary and permanent disabling situations, beyond spending to really know the status of occupational health at all times and to adopt policies to improve. Conclusions: Measures to prevent or alleviate the problems return to work after long working medical disabilities. Within the long-term sick, those that cause real problems to return to work are those that last more than 6 months or extend up to the maximum period of the year, or which are under extension or permanent disabilities revised. It is urgent the development of a map of the disability in Spain, to meet the population at risk, know not only how much (the cost or number) but the causes of prolonged disability. To shorten the long, first and foremost disabilities, which corresponds to the lower right situation indicated or both at the beginning and at the end, not protected shelter situations they cover. That health care is provided in a timely manner, without waiting lists. Protocoled early care units, especially in mental disorders or musculoskeletal. It is essential for greater communication, coordination and cooperation among health care medical field (provision and health care), the medical field evaluation (economic benefits) and the labor of medicine (care, prevention and monitoring occupational health), creating a flow of information between these three areas, promoting access to medical history and knowledge of the skills required by the job using occupational assessment records for workers in temporary disability. We must promote the adequacy of long medical disability situations and adaptation in the return to work and allow the gradual reintegration of the worker "with" high partial to facilitate re-entry into work and prevent relapses.

Palabras clave : incapacity; labour absenteeism; occupational health; return to work; management of return to work.

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