European social security organisations experience shortages of insurance physicians and they attempt to streamline procedures in the disability assessment services in order to save costs, while safeguarding the quality of the assessments. Hence, they look at alternative ways for efficient and cost-effective assessments by transferring insurance physician tasks to other (non)-healthcare professionals. This study, carried out by European Union of Medicine in Assurance and Social Security (EUMASS), aimed to describe and compare the use of task transfer (task shifting, delegation and support) in European social security systems. The approach was threefold: (1) A survey questionnaire was sent to all 20 EUMASS members, inquiring about the present and planned use of task transfer in work disability assessments, and how it has been evaluated; (2) A literature study was undertaken on task transfer; (3) Case studies were carried out in selected countries (Belgium, France, the Netherlands, Norway, the United Kingdom) where different approaches to task transfer have been used. Task transfer in disability assessments has been introduced in seven countries, mostly in Western Europe. A mixture of task shifting, delegation, and support was often used. Nurses were the main group to take over new tasks, but other (non)-healthcare professionals were also involved. Task transfer is implemented in different ways in line with the cultural traditions and the specific organisations that comprise the political and financial framework of the individual country. Education and training were important for a successful change of tasks. The changes were mostly seen as positive. Innovative and flexible approaches are described which can provide examples for other countries and can inform further study.

中文翻译：

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欧洲社会保障中工作残疾评估的任务转移

欧洲社会保障组织面临保险医生短缺的问题，他们试图简化残疾评估服务的程序，以节省成本，同时保障评估质量。因此，他们通过将保险医师的任务转移给其他（非）医疗保健专业人员来寻找有效且具有成本效益的评估的替代方法。本研究由欧洲保险和社会保障医学联盟 (EUMASS) 进行，旨在描述和比较欧洲社会保障体系中任务转移（任务转移、委派和支持）的使用。该方法有三个方面：（1）向所有 20 名 EUMASS 成员发送调查问卷，询问任务转移在工作残疾评估中的当前和计划使用情况，以及如何对其进行评估；(2)对任务转移进行了文献研究；(3) 在使用不同任务转移方法的选定国家（比利时、法国、荷兰、挪威、英国）进行了案例研究。残疾评估中的任务转移已在七个国家引入，主要是在西欧。经常使用任务转移、委派和支持的混合体。护士是接管新任务的主要群体，但其他（非）医疗保健专业人员也参与其中。根据文化传统和构成单个国家政治和财政框架的具体组织，以不同方式实施任务转移。教育和培训对于成功改变任务很重要。这些变化大多被视为积极的。