title: Do claim factors predict health care utilization after transport accidents?
abstract: BACKGROUND
  Injured people who are involved in compensation processes have less recovery and less well-being compared to those not involved in claims settlement procedures. This study investigated whether claim factors, such as no-fault versus common law claims, the number of independent medical assessments, and legal disputes, predict health care utilization after transport accidents.
  
  
  METHODS
  The sample consisted of 68,911 claimants who lodged a compensation claim at the Transport Accident Commission (TAC) in Victoria, Australia, between 2000 and 2005. The main outcome measure was health care utilization, which was defined as the number of visits to health care providers (e.g. general practitioners, physiotherapists, psychologists) during the 5 year period post-accident.
  
  
  RESULTS
  After correction for gender, age, role in accident, injury type, and severity of injury, it was found that independent medical assessments were associated with greater health care utilization (β=.36, p<.001). Involvement in common law claims and legal disputes were both significantly related to health care utilization (respectively β=.05, p<.001 and β=-.02, p<.001), however, the standardized betas were negligible, therefore the effect is not clinically relevant. A model including claim factors predicted the number of health care visits significantly better (ΔR(2)=.08, p<.001) than a model including only gender, age, role in accident, injury type, and severity of injury.
  
  
  CONCLUSIONS
  The positive association between the number of independent medical assessments and health care utilization after transport accidents may imply that numerous medical assessments have a negative effect on claimants' health. However, further research is needed to determine a causal relationship.
authors: VU University Amsterdam, Department of Law, De Boelelaan 1105, Amsterdam, The Netherlands. n.elbers@vu.nl
authors: Nieke A
authors: NA
authors: Elbers
authors: Pim
authors: P
authors: Cuijpers
authors: Arno J
authors: AJ
authors: Akkermans
authors: Alex
authors: A
authors: Collie
authors: Rasa
authors: R
authors: Ruseckaite
authors: David J
authors: DJ
authors: Bruinvels
mesh_terms: D000063:Accidents, Traffic / Q000191:economics / Q000331:legislation & jurisprudence; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D035881:Compensation and Redress / Q000331:legislation & jurisprudence; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007344:Insurance Claim Reporting / Q000331:legislation & jurisprudence; D007346:Insurance, Accident / Q000331:legislation & jurisprudence; D016365:Liability, Legal; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015599:Trauma Severity Indices; D014739:Victoria; D014947:Wounds and Injuries / Q000175:diagnosis / Q000191:economics / Q000209:etiology / Q000628:therapy*