National Academy of Sciences
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce Alberts is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.
The project that is the subject of this report is supported by Contract No. 600-96-27893 between the National Academy of Sciences and the Social Security Administration. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the agency that provided support for this project.
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Copyright 1997 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America.
COMMITTEE TO REVIEW THE SOCIAL SECURITY ADMINISTRATION'S DISABILITY DECISION PROCESS RESEARCH
DOROTHY P. RICE* Chair, Professor Emeritus,
Department of Social and Behavioral Sciences, Institute for Health and Aging, University of California at San Francisco
MONROE BERKOWITZ, Professor of Economics, Emeritus, and Director,
Disability and Health Economics Research, Rutgers University, New Brunswick, New Jersey
RONALD S. BROOKMEYER, Professor of Biostatistics,
The Johns Hopkins University School of Hygiene and Public Health
GERBEN DEJONG, Director,
National Rehabilitation Hospital Research Center, and
Professor of Family Medicine and Adjunct Professor,
Georgetown University Institute of Public Policy, Washington, D.C.
MARSHAL F. FOLSTEIN, Chairman and Professor of Psychiatry,
Tufts University School of Medicine; and
Psychiatrist-in-Chief,
New England Medical Center, Boston
DAVID B. GRAY, Professor and Associate Director for Research,
Program in Occupational Therapy, Washington University School of Medicine
ROBERT M. GROVES, Professor and Program Director,
Survey Research Center of the University of Michigan at Ann Arbor, and
Director of the Joint Program on Survey Methodology at the University of Maryland at College Park
WILLIAM D. KALSBEEK, Professor of Biostatistics and Director,
Survey Research Unit, University of North Carolina at Chapel Hill
JERRY L. MASHAW, Sterling Professor of Law and Management and Professor,
Institute for Social ant Policy Studies, Yale University
CATHARINE C. MASLOW, Director,
Initiative on Alzheimer's and Managed Care, Alzheimer's Association, Washington, D.C.
DONALD L. PATRICK,* Professor of Health Services,
University of Washington School of Public Health and Community Medicine
HAROLD ALAN PINCUS, Deputy Medical Director and Director,
Office of Research, American Psychiatric Association, Washington, D.C.
JOHN A. SWETS,** Chief Scientist,
Information Sciences, BBN Corporation, Cambridge, Massachusetts
EDWARD H. YELIN, Professor of Medicine and Health Policy,
Department of Medicine and Institute for Health Policy Studies, University of California at San Francisco
Study Staff
GOOLOO S. WUNDERLICH, Study Director
KRISTEN N. ROBINSON, Program Officer
MARGO L. CULLEN, Project/Research Assistant
BOARD ON HEALTH CARE SERVICES INSTITUTE OF MEDICINE
DON E. DETMER Chair, Senior Vice President,
The University of Virginia
STUART H. ALTMAN, Sol C. Chaikin Professor of National Health Policy,
The Florence Heller Graduate School for Social Policy, Brandeis University
NANCY W. DICKEY, Private Practice,
College Station, Texas
ANNETINE C. GELIJNS, Associate Professor,
Public Health and Surgery, Columbia University
B. KEN GRAY, Corporate Medical Director,
Metroplex Emergency Physician Associates, P.A., Dallas, Texas
PAUL F. GRINER, Vice President and Director,
Center for the Assessment and Management of Change in Academic Medicine, Association of American Medical Colleges, Washington, D.C.
CLARK C. HAVIGHURST, William Neal Reynolds Professor of Law,
Duke University School of Law
BRENT C. JAMES, Executive Director,
Institute for Health Care Delivery Research, and
Vice President,
Medical Research and Continuing Medical Education, Intermountain Health Care, Salt Lake City, Utah
JACQUELINE KOSECOFF, President and Co-Chief Executive Officer,
Value Health Sciences, Inc., Santa Monica, California
SHEILA T. LEATHERMAN, Executive Vice President,
Center for Health Care Policy and Evaluation, United Health Care Corporation, Minneapolis, Minnesota
JOHN LUDDEN, Senior Vice President for Medical Affairs,
Harvard Pilgrim Health Care, Brookline, Massachusetts
BARBARA J. McNEIL, Ridley Watts Professor,
Department of Health Care Policy, Harvard Medical School
RUSSELL L. MILLER,
State University of New York, Health Science Center, Brooklyn
MILDRED MITCHELL-BATEMAN, Clinical Director,
Huntington Hospital, Huntington, West Virginia
MARY MUNDINGER, Dean and Centennial Professor in Health Policy,
Columbia University
UWE E. REINHARDT, James Madison Professor of Political Economy and Professor of Economics and Public Affairs,
Princeton University
MARY LEE SEIBERT, Acting Provost,
Ithaca College
STEPHEN M. SHORTELL, A.C. Buehler Distinguished Professor of Health Services Management and Professor of Organization Behavior,
Kellogg Graduate School of Management, Northwestern University
GAIL L. WARDEN, President and Chief Executive Officer,
Henry Ford Health System, Detroit, Michigan
CLYDE J. BEHNEY, Deputy Executive Officer and Director,
Board on Health Care Services, IOM
COMMITTEE ON NATIONAL STATISTICS NATIONAL RESEARCH COUNCIL
NORMAN M. BRADBURN Chair,
National Opinion Research Center, University of Chicago
JULIE DaVANZO, RAND,
Santa Monica, California
WILLIAM F. EDDY,
Department of Statistics, Carnegie Mellon University
JOHN F. GEWEKE,
Department of Economics, University of Minnesota, Minneapolis
JOEL B. GREENHOUSE,
Department of Statistics, Carnegie Mellon University
ERIC A. HANUSHEK,
W. Allen Wallis Institute of Political Economy and Department of Economics, University of Rochester
RODERICK J.A. LITTLE,
Department of Biostatistics, University of Michigan
CHARLES F. MANSKI,
Department of Economics, University of Wisconsin, Madison
WILLIAM D. NORDHAUS,
Department of Economics, Yale University
JANET L. NORWOOD,
The Urban Institute, Washington, D.C.
EDWARD B. PERRIN,
School of Public Health and Community Medicine, University of Washington
PAUL R. ROSENBAUM,
Department of Statistics, The Wharton School, University of Pennsylvania
KEITH F. RUST,
Statistical Group, Westat, Inc., Rockville, Maryland
FRANCISCO J. SAMANIEGO,
Division of Statistics, University of California at Davis
MIRON L. STRAF, Director
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