Centre for Health Economics, Monash University, Caulfield East, Victoria, Australia.
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Health Econ. 2023 Jul;32(7):1581-1602. doi: 10.1002/hec.4680. Epub 2023 Apr 1.
Several Organisation for Economic Co-operation and Development countries have constrained Disability Income Insurance (DI) eligibility and reassessed those on DI to encourage workforce participation. But these policies can also have unintended consequences. While receiving less income can directly worsen physical and mental health, the stress related to reassessment and the possibility of losing DI may also adversely affect mental health. This paper uses Australian population-wide administrative data to explore how a 2014 policy - where DI recipients under 35 were reassessed under stricter criteria - affected healthcare use. We exploit this age targeting using a difference-in-difference regression design and find that the policy increased nervous system drug prescriptions (which includes antidepressants). Our findings suggest that the reassessment of DI recipients, even without income loss, may have had a significant negative impact on their mental health. DI reassessment policies may have the unintended consequence of worsening mental health and this needs be considered when deciding if reassessment is worthwhile.
一些经济合作与发展组织国家限制了残疾收入保险（DI）的资格，并重新评估了那些享受 DI 的人，以鼓励他们参与劳动力市场。但这些政策也可能产生意想不到的后果。虽然收入减少会直接恶化身心健康，但与重新评估相关的压力以及失去 DI 的可能性也可能对心理健康产生不利影响。本文使用澳大利亚全人口行政数据，探讨了 2014 年的一项政策（即 35 岁以下的 DI 受助人根据更严格的标准进行重新评估）如何影响医疗保健的使用。我们利用这种年龄靶向性，采用差异中的差异回归设计发现，该政策增加了神经系统药物的处方（包括抗抑郁药）。我们的研究结果表明，即使没有收入损失，对 DI 受助人的重新评估也可能对他们的心理健康产生重大负面影响。DI 重新评估政策可能会产生意想不到的负面影响，即恶化心理健康，在决定重新评估是否值得时，需要对此进行考虑。
