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

Pablo A. Celhay (), Nicolás Figueroa, Carla Guadalupi and Benjamín Oteíza
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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

No 2026-50, Working Papers from Becker Friedman Institute for Research In Economics

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 decreases 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 $12.6 million 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.

Keywords: Health Economics; Physician Behavior; Fraud; Sick Leave; Regulation (search for similar items in EconPapers)
JEL-codes: H51 I11 I18 (search for similar items in EconPapers)
Pages: 34 pages
Date: 2025
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