I. Cassis et al., QUALITY OF WORK INCAPACITY ASSESSMENT IN THE SWISS DISABILITY INSURANCE SYSTEM, International journal for quality in health care, 8(6), 1996, pp. 567-575
Quality of medical assessment of work incapacity has been poorly inves
tigated, despite the enormous costs engendered by transient incapacity
of work and permanent disability, This study examined some indices of
quality from a stratified, random sample (n=120) of assessments perfo
rmed by expert assessors of the Swiss disability insurance, The distri
bution of work incapacity (WI) percentages over a 100% scale showed a
clustering around key values significantly associated with financial d
isability benefits, The precision of WI, expressed as the level of qua
ntitative exactness, was found to be high in 74% (95% CI: 66-82%) of c
urrent WI assessments, and in 62% (95% CI: 53-71%) of maximal WI asses
sments, Disagreement was observed in 17% of cases when comparing two w
ays of expressing WI by the same physician (95% CI: 10-23%), This expl
oratory study is limited by the general lack of objective criteria and
standards, Further theoretical and empirical developments are needed
to determine standardized criteria and clear guidelines for medical as
sessments of WI, as well as for evaluating their quality, Copyright (C
) 1996 Elsevier Science Ltd.