Application of simultaneous equation models to temporary disability prescriptions in primary healthcare centres

Abstract

Non-medical characteristics of primary healthcare centres (PHCs) influence the prescription of temporary disability leaves (incidence and absence rates) due to anxiety, as studied in the Valencian Community (E Spain; 5,111,706 inhabitants, 2009), where 485 centres (66%) were analysed. A structural two-equation model was used to explain which centres’ factors impact prescriptions more. This model determined the influence of PHCs’ factors (location, delay in specialized care, sick leave duration, etc.) on the incidence and absence rates, and on the interdependence between both rates. The results suggest the need to improve centres’ management (clinical guidelines) and labour market regulations, and to control the disability benefits paid.

Keywords:

• sick leave
• disability insurance
• mental disorders
• linear regression
• simultaneous equations

2010 AMS Classifications:

• 62H12
• 62H20
• 62J05
• 62P25

Acknowledgements

The translation of this paper was funded by the Universitat Politècnica de València, Spain. We are grateful to Joaquín Andani for supplying the database.