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Does external medical review reduce disability insurance inflow?

机译：外部医学审查是否减少了残疾保险流入？

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摘要

This paper investigates the effects of introducing external medical review for disability insurance (DI) in a system relying on treating physician testimony for eligibility determination. Using a unique policy change and administrative data from Switzerland, I show that medical review reduces DI incidence by 23%. Incidence reductions are closely tied to difficult-to-diagnose conditions, suggesting inaccurate assessments by treating physicians. Due to a partial benefit system, reductions in full benefit awards are partly offset by increases in partial benefits. More intense screening also increases labor market participation. Existing benefit recipients are downgraded and lose part of their benefit income when scheduled medical reviews occur. Back-of-the-envelope calculations indicate that external medical review is highly cost-effective. Under additional assumptions, the results provide a lower bound of the effect on the false positive award error rate. (C) 2019 Elsevier B.V. All rights reserved.
机译：本文调查了在依托治疗医生证据的系统中引入残疾保险（DI）的效果，以获得资格确定。使用来自瑞士的独特政策变更和管理数据，我表明医学评审将DI发病率降低了23％。发病率降低与难以诊断的条件密切相关，这表明通过治疗医生进行不准确的评估。由于部分福利制度，全面效益奖励的减少部分抵消了部分福利的增加。更激烈的筛选还会增加劳动力市场的参与。在预定的医学评论发生时，现有的福利接受者将降级并失去部分福利收入。背包计算表明，外部医学审查是高度成本效益的。在额外的假设下，结果对伪正奖励率的效果的较低限制提供了较低的界限。 （c）2019 Elsevier B.v.保留所有权利。

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  • 来源
    《Journal of health economics》 |2019年第3期|108-128|共21页
  • 作者

    Liebert Helge;

  • 作者单位

    Univ St Gallen Ctr Disabil & Integrat Dept Econ Rosenbergstr 51 CH-9000 St Gallen Switzerland;

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  • 正文语种 eng
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