The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash.
Time-to-claim-closure is a common outcome in cohort studies of whiplash injuries. However, its relationship to health recovery is unknown. We investigated the association between neck pain, physical functioning, depressive symptomatology and time-to-claim-closure in a Saskatchewan cohort of 5398 whiplash claimants in 1994-1995. Participants were surveyed five times over 1 year. In 1995, the insurance system changed from tort to no-fault, eliminating compensation for pain and suffering. Under tort, a 10-point increase in pain reduced the claim-closure rate by 13-24% while a 10-point increase in physical functioning increased it by 17%. Depressive symptomatology reduced the claim-closure rate by 37%. Under no-fault, a 10-point increase in pain reduced the claim-closure rate by 18% while a 10-point increase in physical functioning increased it by 10-35%. The presence of depressive symptomatology reduced the claim-closure rate by 36%. The results suggests lower pain, better function and the absence of depressive symptoms are strongly associated with faster time-to-claim-closure and recovery after whiplash, independent of the insurance system.
Côté
P
P
Institute for Work & Health, #702-250 Bloor Street East, M4W 1E6, Toronto, ON, Canada. pcote@iwh.on.ca
Hogg-Johnson
S
S
Cassidy
J D
JD
Carroll
L
L
Frank
J W
JW
D000063:Accidents, Traffic / Q000191:economics; D000328:Adult; D002170:Canada; D003863:Depression / Q000191:economics / Q000209:etiology*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D007346:Insurance, Accident / Q000331:legislation & jurisprudence; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000191:economics / Q000209:etiology*; D010147:Pain Measurement; D012525:Saskatchewan; D012959:Socioeconomic Factors; D014911:Whiplash Injuries / Q000150:complications / Q000191:economics* / Q000503:physiopathology*