Active involvement and intervention in patients exposed to whiplash trauma in automobile crashes reduces costs: a randomized, controlled clinical trial and health economic evaluation.
METHODS
To examine and compare the costs and consequences in a partial economic evaluation of two competing interventions in patients exposed to whiplash trauma in automobile crashes. The interventions were an active involvement and intervention using early mobilization and a standard intervention of rest, recommended short-term immobilization in a cervical collar and a cautious, gradual self-exercise program according to a leaflet. The study was randomized and controlled.


OBJECTIVE
The aim of the study was to compare the costs of an active involvement and intervention versus a standard intervention and to relate them to the clinical benefits in patients exposed to whiplash trauma in automobile crashes to facilitate decision-making regarding intervention and resource allocation.


BACKGROUND
There is very little known about the health economic aspects of various interventions in the target treatment group of patients.


METHODS
Based on a prospective, randomized, clinical trial, data on clinical effectiveness and resources used for the active involvement and intervention and standard intervention were collected for a comparative analysis of the costs related to physical therapy treatment and sick leave. A cost-consequence analysis consisting of a modified cost-effectiveness analysis was used.


RESULTS
The costs were significantly lower after 6 and 36 months with an active involvement and intervention as compared with the standard intervention. The active involvement and intervention were significantly superior in reducing experienced pain and reducing sick leave.


CONCLUSIONS
For patients exposed to whiplash trauma in a motor vehicle collision, an active involvement and intervention were both less costly and more effective than a standard intervention.
Rosenfeld
Mark
M
Institute of Neuroscience and Physiology, Division of Physical Therapy, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. mark@rosenfeld.se
Seferiadis
Aris
A
Gunnarsson
Ronny
R
D000063:Accidents, Traffic; D017281:Cost of Illness; D004434:Early Ambulation; D017048:Health Care Costs; D006801:Humans; D010358:Patient Participation; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D012648:Self Care; D018582:Sick Leave; D016037:Single-Blind Method; D014911:Whiplash Injuries / Q000628:therapy*