title: The health status of people claiming compensation for musculoskeletal injuries following road traffic crashes is not altered by an early intervention programme: a comparative study.
abstract: OBJECTIVE
  To compare health outcomes among claimants compared to those who were ineligible or choose not to lodge a compensation claim. We also evaluated the effect of an early intervention programme on the health outcomes of the participants.
  
  
  METHODS
  Prospective comparative study using sequential cohorts.
  
  
  METHODS
  People presenting to hospital emergency departments with mild to moderate musculoskeletal injuries following road traffic crashes.
  
  
  METHODS
  referral to an early intervention programme for assessment by musculoskeletal physician, pain management education, promotion of self-management and encouragement of early activity.
  
  
  RESULTS
  The 36-Item Short-Form Survey (SF-36); Hospital Anxiety and Depression Scale (HADS) and Functional Rating Index (FRI) scores were assessed at post-crash and at 12 months.
  
  
  RESULTS
  At 12 months, mean scores in six and five of the SF-36 domains were significantly lower among participants who claimed compensation versus those who chose not to claim or were ineligible, respectively. Differences in mean SF-36 scores ranged from 3.0 ('general health perception') to 8.0 units ('role limitations due to physical problems'). Participants who claimed compensation had 6.3- and 4.6-units lower SF-36 physical component score compared to those who were ineligible (p=0.001) or chose not to claim (p=0.01), respectively. Participants who claimed compensation reported a worse HADS-depression score of 6.46 versus 4.97 and 4.69 observed in those who were ineligible (p=0.04) or did not claim (p=0.01). Claimants had worse FRI scores compared to non-claimants (p=0.01) and those who were ineligible (p=0.01). The early intervention did not improve health outcomes, 12 months after injury.
  
  
  CONCLUSIONS
  Claiming compensation was associated with a worse health status for people with soft tissue injuries caused by road traffic crashes. The health status in people claiming compensation was not altered by an early intervention programme.
authors.affiliation: College of Medicine, Biology and Environment, Australian National University, Australia. Electronic address: susannah.littleton@alumni.anu.edu.au.
authors.forename: S M
authors.initials: SM
authors.lastname: Littleton
authors.affiliation: College of Medicine, Biology and Environment, Australian National University, Australia.
authors.forename: D C
authors.initials: DC
authors.lastname: Hughes
authors.affiliation: Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Gopinath
authors.affiliation: College of Medicine, Biology and Environment, Australian National University, Australia.
authors.forename: B J
authors.initials: BJ
authors.lastname: Robinson
authors.affiliation: College of Medicine, Biology and Environment, Australian National University, Australia.
authors.forename: S J
authors.initials: SJ
authors.lastname: Poustie
authors.affiliation: College of Medicine, Biology and Environment, Australian National University, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Australia.
authors.forename: P N
authors.initials: PN
authors.lastname: Smith
authors.affiliation: Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Australia.
authors.forename: I D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000056:Accident Prevention; D000063:Accidents, Traffic / Q000191:economics / Q000517:prevention & control / Q000706:statistics & numerical data*; D000328:Adult; D001315:Australia / Q000453:epidemiology; D035881:Compensation and Redress; D004185:Disability Evaluation; D061345:Early Medical Intervention; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012017:Referral and Consultation
keywords: Accident; Compensation; Early intervention; Health status; Soft tissue injury; Traffic