The effect of compensation on health care utilisation in a trauma cohort.
OBJECTIVE
To determine whether there is an association between compensation factors and health care utilisation following major trauma.


METHODS
Retrospective cohort study within a major metropolitan trauma centre in New South Wales.


METHODS
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%).


METHODS
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.


CONCLUSIONS
Compensation-related factors are significant predictors of health care utilisation in a major trauma population.
Harris
Ian A
IA
South West Sydney Clinical School, University of New South Wales, Sydney, NSW. ianharris@unsw.edu.au
Murgatroyd
Darnel F
DF
Cameron
Ian D
ID
Young
Jane M
JM
Solomon
Michael J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D035881:Compensation and Redress / Q000331:legislation & jurisprudence*; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014193:Trauma Centers / Q000191:economics / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000191:economics* / Q000628:therapy; D055815:Young Adult