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The effect of compensation on health care utilisation in a trauma cohort
Author(s) -
Harris Ian A,
Murgatroyd Darnel F,
Cameron Ian D,
Young Jane M,
Solomon Michael J
Publication year - 2009
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2009.tb02589.x
Subject(s) - medicine , health care , cohort , musculoskeletal injury , occupational safety and health , odds ratio , population , cohort study , retrospective cohort study , family medicine , emergency medicine , physical therapy , environmental health , alternative medicine , pathology , economics , economic growth
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 ≥ 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 ≥ 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.