K. Dupriez et Jp. Vader, VARIATIONS IN REFERRAL TO MEDICAL ASSESSM ENT-CENTERS OF DISABILITY INSURANCE IN SWITZERLAND - THE ROLE OF REFERANTS, Sozial- und Praventivmedizin, 41(6), 1996, pp. 387-394
The Commissions of the Swiss Disability insurance (CDI) in order to ev
aluate the degree of disability which determines the right to benefits
, can call upon Medical Observation Centers (MOCD) for a pluridiscipli
nary examination. The utilization rate of the MOCD, by the 28 CDI, var
ies by a factor of 1 to 50. The goal of this study is to identify the
causes of this variation related to the differences in CDI practice. T
he CDI answered a mail survey. For analysis, they are allocated into 3
groups of equal size: Low, medium and high users of MOCD. There is no
association between the use of the official and non-official criteria
for referral to MOCD and utilization rate of the MOCD. The CDI have a
false perception of their MOCD use; 40% of thorn underestimate it. Co
nsidering together the utilization rate of the substitutes and of the
MOCD, variation still persists from 1 to 9 among the CDI. There is no
difference in the reasons for non-referral to the MOCD according to th
e level of utilization. This study failed to identify the causes of th
e utilization differences of the MOCD by the CDI. Other factors should
be examined.