QUALITY OF WORK INCAPACITY ASSESSMENT IN THE SWISS DISABILITY INSURANCE SYSTEM

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.