REGIONAL VARIATIONS IN THE USE OF MEDICAL OBSERVATION CENTERS OF THE DISABILITY INSURANCE IN SWITZERLAND

The Medical Observation Centres of the state Disability Insurance (COM AI) are specialized agencies serving the cantonal commissions of the D isability Insurance in Switzerland. Using data collected for each case examined by the COMAI, utilisation rates and rankings were establishe d for each canton. Utilisation rates varied by a factor of 40 from one canton to the next. This observed variation is independent of the num ber of new cases presenting to the Disability Insurance and of the num ber of disability pensions granted. Rankings were also independent of denominators used to define utilisation rates. These results suggest p ossible non-uniform application of state directives concerning the use of the COMAI, and unequal access to these specialized agencies. The r easons for these variations are the object of a study now underway.