Abstract
Objective
To evaluate the effect of claiming compensation on health status for people with mild to moderate injuries sustained in road traffic collisions (RTC).
Methods
The design was a prospective cohort study in the Australian Capital Territory (ACT), Australia and a fault based compensation system. The subjects were people with mild to moderate musculoskeletal injuries who presented to the emergency department within 7 days of an RTC. Outcome Measures were Physical Component Score (PCS) and Mental Component Score (MCS) of the Short Form 36 (SF-36) health status measure; Hospital Anxiety and Depression Scale (HADS); and the Functional Rating Index (FRI). These measures were recorded immediately RTC, and at 6 and 12 months.
Results
Ninety-five people were enrolled a mean of 8.6 days following RTC; 86% were followed up at 12 months. Mean age was 37 years; 61% were female; and 91% were employed at the time of injury. Compensation was claimed by 33% of enrolled subjects, and 25% engaged a lawyer. There were no significant differences in patient demographics or injury-related factors between the groups. As expected, passengers and people involved in multiple vehicle crashes more frequently claimed compensation. At each time-point, claiming compensation resulted in significantly worse scores for SF-36 PCS (-5.5 (95%CI -8.6 to -2.4), p = 0.001), HADS Anxiety (1.7 (95%CI 0.17 to 3.3), p = 0.048), and FRI (11.2 (95%CI 3.9 to 18.5), p = 0.003). For both groups, health status improved at the same rate, with significant improvement between baseline and 6 months, but no further improvement between 6 and 12 months.
Conclusion
Claiming compensation had a significant negative effect on health status following mild to moderate musculoskeletal injuries sustained in RTC. However, whether this negative effect was due to claiming compensation itself or the presence of other unmeasured factors cannot be determined.
