OZLJEDE NA RADU I OCJENA PRIVREMENE RADNE NESPOSOBNOSTI U OSIGURATELJNOJ PRAKSI
Sitar-Srebočan V, Bradić V, Frković D.
Croatia osiguranje d.d. Zagreb,Zagreb, Hrvatska

CILJ: U odštetnim zahtjevima Croatia osiguranju d.d., za nadoknadu troškova zbog ozljeda na radu u Obveznom zdravstvenom osiguranju poslodavatelja, željelo se utvrditi da li postoji razlika u ozljeđivanju prema spolu, koje su najčešće ozljede, duljinu privremene radne nesposobnosti za iste, te da li je bolovanje u skladu s duljinom bolovanja Pravilnika Hrvatskog zavoda za zdravstveno osiguranje.

MATERIJAL I METODE: Metodom slučajnog uzorka odabrana su i potom analizirana 104 odštetna zahtjeva za nadoknadu troškova za ozljede na radu, nastale u Zagrebu, u razdoblju od 1999-2002. godine.

REZULTATI: Među ozljeđenima bilo je 58% muškaraca i 42% žena.Najčešće su bile ozljede ruku i nogu 21,1%, zatim glave i vratne kralježnice 17,3%, akutni stresni poremećaj uzrokovan životnom ugroženošću na poslu, te ozljede prsišta po 7,6 %, dok su ostale ozljede bile manje zastupljene. Na našem uzorku je prosječna duljina bolovanja, za sve promatrane dijagnoze, bila u skladu s Pravilnikom, osim za ozljede vratne kralježnice kod kojih je, osobito ako se radilo o ženama bila 1,5 puta dulja od predviđenog.

ZAKLJUČAK: Naši rezultati ukazuju da su izabrani liječnici uglavnom objektivno ocjenjivali privremenu radnu nesposobnost osim kod trzajne ozljede vratne kralježnice koja i dalje ostaje problem i zdravstva i osiguratelja.

OCCUPATIONAL INJURIES AND EVALUATION OF TEMPORARY WORKING DISABILITY IN INSURANCE PRACTICE
Sitar- Srebočan V, Bradić V, Frković D.
Croatia insurance company Zagreb, Zagreb, Croatia

AIM: In damage claims for occupational injuries Croatia Insurance Company in Employer' s obligatory health insurance wanted to determine: which injuries are most common, is there a difference in injuring according to gender. And assess average temporary working disability for every type of injury and if this is in coherence with The Regulations' time limit for sick leaves by Croatian National Institute for Health Insurance.

MATERIAL AND METHODS:104 claims for occupational injuries in Zagreb from 1999-2002 were examined.

RESULTS: Among injured there were 58% men and 42% women. Most common injuries were those of arms and legs - 21.1%, those of head and whiplash injury - 17.3%, direct stress related disorder due to risking life at work and chest injuries - 7.6%. Other injuries were represented in small percentages. In analysed sample the periods of sick leaves were coherent with The Regulations, except for whiplash injuries where sick leaves were longer up to 1.5 times than anticipated by The Regulations; especially at women.

CONCLUSION: Our results show that chosen doctors in most cases objectively assessed temporary working disability, with the exception of whiplash injury that continues to be the problem of Public Health and Insurance.