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The medical doctors as gatekeepers in the sickness insurance?

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  • Per Engström
  • Per Johansson

Abstract

Based on a randomized experiment, we estimate effects from notification to medical doctors of tighter monitoring of their Medical Certificates (MCs). Both the time prescribed by the doctor certificates for sick leave (prescribed sick leave) and the impact on the length of the actual sickness absence (actual sick leave) is studied. We find no effect on the total number of prescribed sick leave days. However, we do find an increase in both prescribed and actual sick leave with a 25% work inability. We also find that the notification letter causes an increase in actual sick leave (i.e. the number of reimbursed sick days). We discuss a number of potential explanations for this rather surprising result.

Suggested Citation

  • Per Engström & Per Johansson, 2012. "The medical doctors as gatekeepers in the sickness insurance?," Applied Economics, Taylor & Francis Journals, vol. 44(28), pages 3615-3625, October.
    • Handle: RePEc:taf:applec:44:y:2012:i:28:p:3615-3625
    DOI: 10.1080/00036846.2011.579064
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    References listed on IDEAS

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    1. Lindbeck, Assar & Palme, Mårten & Persson, Mats, 2007. "Social Interaction and Sickness Absence," Working Paper Series 725, Research Institute of Industrial Economics.
    2. Hesselius, Patrik & Johansson, Per & Nilsson, Peter, 2009. "Sick of your colleagues' absence?," Working Paper Series 2009:2, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    3. Magnus Henrekson & Mats Persson, 2004. "The Effects on Sick Leave of Changes in the Sickness Insurance System," Journal of Labor Economics, University of Chicago Press, vol. 22(1), pages 87-114, January.
    4. Johansson, Per & Palme, Marten, 1996. "Do economic incentives affect work absence? Empirical evidence using Swedish micro data," Journal of Public Economics, Elsevier, vol. 59(2), pages 195-218, February.
    5. Johansson, Per & Palme, Mårten, 1998. "Assessing the effect of a compulsory sickness insurance on worker absenteeism," SSE/EFI Working Paper Series in Economics and Finance 287, Stockholm School of Economics.
    6. Johansson, Per & Palme, Marten, 2005. "Moral hazard and sickness insurance," Journal of Public Economics, Elsevier, vol. 89(9-10), pages 1879-1890, September.
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    Cited by:

    1. Avdic, Daniel & Johansson, Per, 2013. "Gender Differences in Preferences for Health-Related Absences from Work," IZA Discussion Papers 7480, Institute of Labor Economics (IZA).
    2. Assar Lindbeck & Mårten Palme & Mats Persson, 2016. "Sickness Absence and Local Benefit Cultures," Scandinavian Journal of Economics, Wiley Blackwell, vol. 118(1), pages 49-78, January.
    3. Lombardi, Stefano & Skans, Oskar Nordström & Vikström, Johan, 2018. "Targeted wage subsidies and firm performance," Labour Economics, Elsevier, vol. 53(C), pages 33-45.
    4. Carlo Alberto Biscardo & Alessandro Bucciol & Paolo Pertile, 2015. "Who should monitor job sick leave?," Working Papers 18/2015, University of Verona, Department of Economics.
    5. Carlo Alberto Biscardo & Alessandro Bucciol & Paolo Pertile, 2019. "Job sick leave: Detecting opportunistic behavior," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 373-386, March.

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    More about this item

    JEL classification:

    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply

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