Abstract

BackgroundA high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned.Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal.FindingsWe analysed 3165 medical appraisals, 2444 (77%) of them from the public disability insurance, 678 (22%) from private accident, liability and loss of income insurances and 43 (1%) from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3).ConclusionsFrom the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time.

Highlights

  • A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job

  • Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time

  • Social insurances, such as the disability insurance or loss of income insurances, play an important role in Switzerland for patients with chronic medical conditions, who are in danger to lose their job

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Summary

Introduction

A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. The unit of sample was the medical appraisal Social insurances, such as the disability insurance or loss of income insurances, play an important role in Switzerland for patients with chronic medical conditions, who are in danger to lose their job. By help of medical appraisals, insurances try to get a complete picture of deficiencies and resources of such patients to judge occupational reintegration measures, for example in case of musculoskeletal or psychiatric disorders [1]. A high quality of timely delivered medical appraisals is crucial for staff of insurances to base their decisions on possible reintegration measures on solid ground [2]. Assessors synthesize information from medical and psycho-social history as well as from patient examination, conclude on the overall situation of the patient and reply to key questions of insurances

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