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The Effects of Intervening the Supply Side of Fraudulent Sick Leaves Market in Chile

Author

Listed:
  • Pablo A. Celhay

    (Pontificia Universidad Católica de Chile)

  • Nicolás Figueroa

    (Pontificia Universidad Católica de Chile)

  • Carla Guadalupi

    (Universidad Andrés Bello)

  • Benjamín Oteíza

    (Pontificia Universidad Católica de Chile)

Abstract

This paper examines the effects of a crackdown on fraudulent sick leave in Chile, where 176 doctors were sanctioned for issuing excessive certificates. Physician decisions are influenced by patient needs and incentives,often resulting in suboptimal care. We analyze whether audits and sanctions change doctor behavior, whether non-sanctioned doctors are affected, and how patient behavior responds. Using data on around 22 million sick leaves from January 2018 to October 2022, we apply difference-in-differences (DiD)and regression discontinuity in time (RDiT) methods. Results show a 40.49%reduction in sick leave issuance among sanctioned doctors (DiD) and decreased between 34.46% and 50.12% (RDiT). We also find spillover effects: non-sanctioned doctors reduced issuing sick leaves by 9.33% to 14.19% after the intervention. On the demand side, patients treated by sanctioned doctors experienced an 18.94% decline in sick leave usage, saving approximately $12.6million for the public insurer. Overall, sanctions on doctors effectively reduced sick leave issuance, partly due to patients switching providers, highlighting how supply-side interventions can influence healthcare practices and patient behavior.

Suggested Citation

  • Pablo A. Celhay & Nicolás Figueroa & Carla Guadalupi & Benjamín Oteíza, 2025. "The Effects of Intervening the Supply Side of Fraudulent Sick Leaves Market in Chile," Working Papers 2026-50, Becker Friedman Institute for Research In Economics.
    • Handle: RePEc:bfi:wpaper:2026-50
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