The health status of people claiming compensation for musculoskeletal injuries following road traffic crashes is not altered by an early intervention programme: a comparative study

S M Littleton; D C Hughes; B Gopinath; B J Robinson; S J Poustie; P N Smith; I D Cameron

doi:10.1016/j.injury.2014.05.011

The health status of people claiming compensation for musculoskeletal injuries following road traffic crashes is not altered by an early intervention programme: a comparative study

Injury. 2014 Sep;45(9):1493-9. doi: 10.1016/j.injury.2014.05.011. Epub 2014 May 20.

Authors

S M Littleton¹, D C Hughes², B Gopinath³, B J Robinson², S J Poustie², P N Smith⁴, I D Cameron³

Affiliations

¹ College of Medicine, Biology and Environment, Australian National University, Australia. Electronic address: susannah.littleton@alumni.anu.edu.au.
² College of Medicine, Biology and Environment, Australian National University, Australia.
³ Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Australia.
⁴ College of Medicine, Biology and Environment, Australian National University, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Australia.

PMID: 24931358
DOI: 10.1016/j.injury.2014.05.011

Abstract

Objective: To compare health outcomes among claimants compared to those who were ineligible or choose not to lodge a compensation claim. We also evaluated the effect of an early intervention programme on the health outcomes of the participants.

Design: Prospective comparative study using sequential cohorts.

Subjects: People presenting to hospital emergency departments with mild to moderate musculoskeletal injuries following road traffic crashes.

Intervention: referral to an early intervention programme for assessment by musculoskeletal physician, pain management education, promotion of self-management and encouragement of early activity.

Main outcomes: The 36-Item Short-Form Survey (SF-36); Hospital Anxiety and Depression Scale (HADS) and Functional Rating Index (FRI) scores were assessed at post-crash and at 12 months.

Results: At 12 months, mean scores in six and five of the SF-36 domains were significantly lower among participants who claimed compensation versus those who chose not to claim or were ineligible, respectively. Differences in mean SF-36 scores ranged from 3.0 ('general health perception') to 8.0 units ('role limitations due to physical problems'). Participants who claimed compensation had 6.3- and 4.6-units lower SF-36 physical component score compared to those who were ineligible (p=0.001) or chose not to claim (p=0.01), respectively. Participants who claimed compensation reported a worse HADS-depression score of 6.46 versus 4.97 and 4.69 observed in those who were ineligible (p=0.04) or did not claim (p=0.01). Claimants had worse FRI scores compared to non-claimants (p=0.01) and those who were ineligible (p=0.01). The early intervention did not improve health outcomes, 12 months after injury.

Conclusions: Claiming compensation was associated with a worse health status for people with soft tissue injuries caused by road traffic crashes. The health status in people claiming compensation was not altered by an early intervention programme.

Keywords: Accident; Compensation; Early intervention; Health status; Soft tissue injury; Traffic.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Accident Prevention
Accidents, Traffic / economics
Accidents, Traffic / prevention & control
Accidents, Traffic / statistics & numerical data*
Adult
Australia / epidemiology
Compensation and Redress*
Disability Evaluation
Early Medical Intervention*
Female
Health Status
Humans
Male
Prospective Studies
Quality of Life*
Referral and Consultation