Objectives: To develop a model for detecting cases of organized fraud in Chile based on data from the legal forms for medically authorized leave (formulario legal de licencia médica curativa-MAL) and to establish the relevance of this data to fraud detection.
Methods: A binomial logistic regression model was employed using four variables from the MAL form, a national requirement for illness-related work absences: the number of legal absences taken by a single person, the number of days authorized by the prescribing doctor, the total cost per illness, and a dichotic variable reflecting whether or not the diagnosis is one that can be proven. The analysis involved 4,079 MAL forms that had been submitted in 2003 to a private health provider and of which 356 were already identified as fraudulent by a panel of medical fraud experts.
Background: The issue of medically justified work absenteeism has a great relevance in Chile at the present moment.
Aim: To analyze sick leaves among people working in hospitals, mines, automotive industry and universities.
Material And Methods: Analysis of 14 thesis and research papers about absenteeism in Chile.