The effect of compensation on health care utilisation in a trauma cohort

Med J Aust. 2009 Jun 1;190(11):619-22. doi: 10.5694/j.1326-5377.2009.tb02589.x.

Abstract

Objective: To determine whether there is an association between compensation factors and health care utilisation following major trauma.

Design and setting: Retrospective cohort study within a major metropolitan trauma centre in New South Wales.

Participants: Major trauma patients aged > or = 18 years, admitted between May 1999 and April 2004. Patients were included if they had an accidental injury and an Injury Severity Score > 15. In total, 355 of 582 potentially contactable patients returned completed questionnaires (response rate, 61%).

Main outcome measure: Health care utilisation, defined as the number of times patients visited specified health care professionals (general practitioners, medical specialists, psychiatrists, physiotherapists, chiropractors and massage therapists) in the previous 3 months. For statistical analysis, health care utilisation was dichotomised into low and high (0-3 or > or = 4 health care visits over the previous 3 months).

Results: Health care utilisation was significantly higher for patients engaging the services of a lawyer (odds ratio, 3.3; 95% CI, 2.0-5.5; P < 0.001) after allowing for time since injury, chronic illness, presence of a head injury and employment status. Having a head injury and increased time since injury were significantly associated with lower health care utilisation, whereas being unemployed and having a chronic illness were associated with higher health care utilisation.

Conclusion: Compensation-related factors are significant predictors of health care utilisation in a major trauma population.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Compensation and Redress / legislation & jurisprudence*
  • Delivery of Health Care / economics
  • Delivery of Health Care / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • New South Wales
  • Retrospective Studies
  • Surveys and Questionnaires
  • Trauma Centers / economics
  • Trauma Centers / statistics & numerical data*
  • Wounds and Injuries / economics*
  • Wounds and Injuries / therapy
  • Young Adult