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Closing the Gates? Evidence from a Natural Experiment on Physicians' Sickness Certification

Author

Listed:
  • Markussen, Simen

    (Dept. of Economics, University of Oslo)

Abstract

This paper exploits a Norwegian physician directed reform aimed to reduce sick-leave. Physicians were required to consider part-time sick-leave as the default treatment and – in the case of long lasting full-time sick-leave – to file a report documenting why the worker was unable to perform any work related activities. The reform had a large impact, reducing sick-leave by 18.8 percent. The main effect came from reduced spell duration – which can be directly linked to the extended documentation requirement laid on physicians within the first 8 weeks of a sick-leave spell. Physician-directed policies may be an (cost-) effective way of reducing sick-leave.

Suggested Citation

  • Markussen, Simen, 2009. "Closing the Gates? Evidence from a Natural Experiment on Physicians' Sickness Certification," Memorandum 19/2009, Oslo University, Department of Economics.
  • Handle: RePEc:hhs:osloec:2009_019
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    File URL: https://www.sv.uio.no/econ/english/research/unpublished-works/working-papers/pdf-files/2009/Memo-19-2009.pdf
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    References listed on IDEAS

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    1. Abadie, Alberto & Gay, Sebastien, 2006. "The impact of presumed consent legislation on cadaveric organ donation: A cross-country study," Journal of Health Economics, Elsevier, vol. 25(4), pages 599-620, July.
    2. Jan Erik Askildsen & Espen Bratberg & Øivind Anti Nilsen, 2005. "Unemployment, labor force composition and sickness absence: a panel data study," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1087-1101.
    3. Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2007. "Gatekeeping in health care," Journal of Health Economics, Elsevier, vol. 26(1), pages 149-170, January.
    4. Lindbeck, Assar & Palme, Mårten & Persson, Mats, 2006. "Job Security and Work Absence: Evidence form a Natural Experiment," Seminar Papers 743, Stockholm University, Institute for International Economic Studies.
    5. Arai, Mahmood & Thoursie, Peter Skogman, 2005. "Incentives and selection in cyclical absenteeism," Labour Economics, Elsevier, vol. 12(2), pages 269-280, April.
    6. Johansson, Per & Palme, Marten, 2005. "Moral hazard and sickness insurance," Journal of Public Economics, Elsevier, vol. 89(9-10), pages 1879-1890, September.
    7. Carlsen, Benedicte & Nyborg, Karine, 2009. "The Gate is Open: Primary Care Physicians as Social Security Gatekeepers," Memorandum 07/2009, Oslo University, Department of Economics.
    8. John Beshears & James J. Choi & David Laibson & Brigitte C. Madrian, 2009. "The Importance of Default Options for Retirement Saving Outcomes: Evidence from the United States," NBER Chapters,in: Social Security Policy in a Changing Environment, pages 167-195 National Bureau of Economic Research, Inc.
    9. Brown, Sarah & Sessions, John G, 1996. " The Economics of Absence: Theory and Evidence," Journal of Economic Surveys, Wiley Blackwell, vol. 10(1), pages 23-53, March.
    10. Blomqvist, Ake, 1991. "The doctor as double agent: Information asymmetry, health insurance, and medical care," Journal of Health Economics, Elsevier, vol. 10(4), pages 411-432.
    11. Johnson, Eric J & Hershey, John & Meszaros, Jacqueline & Kunreuther, Howard, 1993. "Framing, Probability Distortions, and Insurance Decisions," Journal of Risk and Uncertainty, Springer, vol. 7(1), pages 35-51, August.
    12. Dusheiko, Mark & Gravelle, Hugh & Jacobs, Rowena & Smith, Peter, 2006. "The effect of financial incentives on gatekeeping doctors: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 25(3), pages 449-478, May.
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    Citations

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    Cited by:

    1. Simen Markussen & Knut Røed, 2015. "Social Insurance Networks," Journal of Human Resources, University of Wisconsin Press, vol. 50(4), pages 1081-1113.
    2. Markussen, Simen & Røed, Knut & Røgeberg, Ole J. & Gaure, Simen, 2011. "The anatomy of absenteeism," Journal of Health Economics, Elsevier, vol. 30(2), pages 277-292, March.
    3. Bütikofer, A. & Skira, M., 2015. "Missing work is a pain: the effect of Cox-2 inhibitors on sickness absence and disability pension receipt," Health, Econometrics and Data Group (HEDG) Working Papers 15/13, HEDG, c/o Department of Economics, University of York.
    4. Bratberg, Espen & Monstad, Karin, 2015. "Worried sick? Worker responses to a financial shock," Labour Economics, Elsevier, vol. 33(C), pages 111-120.
    5. Erik Biørn & Simen Gaure & Simen Markussen & Knut Røed, 2013. "The rise in absenteeism: disentangling the impacts of cohort, age and time," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(4), pages 1585-1608, October.
    6. Markussen, Simen & Mykletun, Arnstein & Røed, Knut, 2012. "The case for presenteeism — Evidence from Norway's sickness insurance program," Journal of Public Economics, Elsevier, vol. 96(11), pages 959-972.

    More about this item

    Keywords

    Labor market policies; sick-leave; physicians’ gate keeping;

    JEL classification:

    • H53 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Welfare Programs
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J28 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Safety; Job Satisfaction; Related Public Policy

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