On the basis of a systematic review of the literature, this article addresses the issue of employment of people with disabilities and analyzes current trends in disability employment to classify employment in social enterprises in the typology of employment models for people with disabilities. For the purpose of classification, the article also identifies individual models of disability which coincide with the characteristics of employment in social enterprises. The upgraded typology is the main contribution of the article; it could serve as an important classification tool for individual approaches to this issue, and thus help to develop appropriate policies for the employment of people with disabilities through a comparative analysis of individual countries. Keywords: employment, typology of employment models, people with disabilities, social enterprises, work-integration social enterprises, models of disability
Uvod: Demografsko staranje predstavlja v zadnjem času velik izziv, s katerim se sooča večina evropskih držav, tudi Slovenija. Ob daljšanju življenjske dobe se mnogi starejši soočajo z eno ali več kroničnimi boleznimi, odvisnostjo od drugih, oslabljenostjo in krhkostjo. A stanje krhkosti ni nepovratna posledica staranja ; izziv, s katerim se soočamo ob podaljševanju življenjske dobe je doseganje čvrste, nekrhke, zdrave in samostojne starosti. Namen: Namen dela je proučiti razširjenost in pojavnost sindroma krhkosti pri starejših odraslih (starih 65 let in več) v Sloveniji in ovrednotiti razlike v primerjavi z Evropo. Metode: Izvedli smo retrospektivno raziskavo razširjenosti in pojavnosti sindroma krhkosti v Sloveniji in Evropi na podlagi podatkov iz raziskave o zdravju, procesu staranja in upokojevanju v Evropi - SHARE. Uporabili smo podatke za leto 2011 (val 4), 2013 (val 5) in 2015 (val 6), pri čemer smo krhkost ovrednotili na podlagi validirane metode SHARE fenotip krhkosti. Analizirali smo razširjenost in pojavnost sindroma krhkosti v Sloveniji in Evropi, ter izvedli primerjavo razširjenosti med Slovenijo in Evropo, in sicer po spolu, starostnih skupinah, izobrazbi, samooceni zdravja, polifarmakoterapiji, geografskih regijah (v Sloveniji) in državah (v Evropi). Rezultati: Razširjenost sindroma krhkosti med starejšimi odraslimi v letu 2015 je bila v Sloveniji 14,2% (95% CI: 12,7-15,6%), v Evropi pa 15,4% ; 95% CI: 14,8-15,9%). Razširjenost predkrhkosti v Sloveniji je bila 41,8% (v Evropi: 44,4%). Med leti 2011 (18,1%), 2013 (17,0%) in 2015 (14,2%) je razširjenost krhkosti v Sloveniji padala. Štiriletna pojavnost (2011-2015) sindroma krhkosti je bila v Sloveniji 4,4 % (95% CI: 2,1-6,7%), v Evropi 5,4 % (95% CI: 4,9-5,9%). Večja razširjenost in pojavnosti krhkosti je pri ženskah, narašča s starostjo, večja je pri nižje izobraženih ljudeh ter osebah s polifarmakoterapijo. Več kot 45% krhkih posameznikov v Sloveniji in Evropi svoje zdravje ocenjuje kot slabo. Najmanjša razširjenost krhkosti je na gorenjskem (8,5%), največja v pomurski regiji (22,2%), v Evropi pa v splošnem narašča od severne proti južni Evropi. Statistično značilen vpliv na krhkost ima spol (v Evropi), starost, izobrazba (v Evropi), samoocena zdravja, polifarmakoterapija ter tudi nekatere regije v severovzhodni Sloveniji in države v Evropi. Zaključki: V prihodnosti bi bilo smiselno poenotiti metodologijo določanja krhkosti ter poenotiti definicijo pojavnosti krhkosti in predkrhkosti, da bi bili rezultati raziskav v različnih državah lažje primerljivi. ; Introduction: Demographic ageing affects most of the European countries, including Slovenia. Increased life expectancy is associated with higher prevalence of chronic diseases, disability, weakness and frailty. Nevertheless, frailty is not an irreversible one-way process. Current challenge for modern healthcare systems is providing non-frail, healthy and independent aging. Aim: The aim of this master's thesis is to evaluate prevalence and incidence of frailty syndrome in older adults (⡥ 65 years) in Slovenia and examine differences compared to other European countries. Methods: Retrospective study of prevalence and incidence of frailty syndrome in Slovenia and Europe was conducted, using the data from Survey of Health, Ageing & Retirement in Europe (SHARE). We used data collected in 2011 (wave 4), 2013 (wave 5) and 2015 (wave 6). Frailty was defined according to validated SHARE Frailty Phenotype method. Prevalence and incidence of frailty in Slovenia and Europe was analyzed, including comparison between Slovenia and Europe, using variables: sex, age categories, education, self-rated health, polypharmacy, statistical regions (Slovenia) and countries (Europe). Results: The overall prevalence of frailty in Slovenia (2015) was 14.2% (95% CI: 12.7-15.6 %), in Europe 15.4% (95% CI: 14.8-15.9%). Prevalence of pre-frailty was 41.8% (Europe: 44.4%). Prevalence in Slovenia was decreasing throughout years: 2011 (18.1%), 2013 (17.0%) and 2015 (14.2%). Four-year incidence of frailty syndrome (2011-2015) was 4.4% (95% CI: 2.1-6.7%) in Slovenia and 5.4% (95% CI: 4.9-5.9%) in Europe. Frailty prevalence and incidence increased with age, and were more frequent among women and participants with lower education and older adults with polypharmacy. More than 45% of older adults in Slovenia and Europe self-assessed their health as bad. Frailty prevalence varies across statistical regions in Slovenia. The proportion of frailty or prefrailty was in general higher in southern than in northern Europe. The variables that are significantly related to prevalence of frailty are gender (female, Europe), age, education (Europe), self-rated health, polypharmacy, some statistical regions in Slovenia and countries in Europe. Conclusions: Unified methodology for evaluating frailty is necessary for easier comparison of results between countries. Moreover, a harmonized definition of measuring frailty incidence may be useful.
