VARIATIONS IN REFERRAL TO MEDICAL ASSESSM ENT-CENTERS OF DISABILITY INSURANCE IN SWITZERLAND - THE ROLE OF REFERANTS

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.