Petrina P Casey1, Anne Marie Feyer2, Ian D Cameron3. 1. John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia. Electronic address: pcas0573@uni.sydney.edu.au. 2. Transport and Road Safety Research (TARS), University of NSW, Sydney, NSW, Australia. 3. Rehabilitation Medicine, John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia.
Abstract
CONTEXT: Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system. STUDY OBJECTIVE: To identify the associations of extended time receiving compensation benefits with the aim of developing a prognostic model that predicts time to claim closure. STUDY DESIGN: Prospective cohort study in people with whiplash associated disorder. OUTCOME MEASURES: Time to claim closure, in a privately underwritten fault based third party traffic crash insurance scheme in New South Wales, Australia. METHOD: Cox proportional hazard regression modelling. RESULTS: Of the 246 participants, 25% remained in the compensation system longer than 24 months with 15% remaining longer than three years. Higher initial disability (Functional Rating Index≥25 at baseline) (HRR: 95% CI, 1.916: 1.324-2.774, p<0.001); and lower initial mental health as measured by SF-36 Mental Component Score (HRR: 95% CI, 0.973: 0.960-0.987, p<0.001) were significantly and independently associated with an increased time-to-claim closure. Shorter time to claim closure was associated with having no legal involvement (HRR: 95% CI, 1.911: 1.169-3.123, p=0.009); and, not having a prior claim for compensation (HRR: 95% CI, 1.523: 1.062-2.198, p=0.022). CONCLUSIONS: Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants.
CONTEXT: Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system. STUDY OBJECTIVE: To identify the associations of extended time receiving compensation benefits with the aim of developing a prognostic model that predicts time to claim closure. STUDY DESIGN: Prospective cohort study in people with whiplash associated disorder. OUTCOME MEASURES: Time to claim closure, in a privately underwritten fault based third party traffic crash insurance scheme in New South Wales, Australia. METHOD: Cox proportional hazard regression modelling. RESULTS: Of the 246 participants, 25% remained in the compensation system longer than 24 months with 15% remaining longer than three years. Higher initial disability (Functional Rating Index≥25 at baseline) (HRR: 95% CI, 1.916: 1.324-2.774, p<0.001); and lower initial mental health as measured by SF-36 Mental Component Score (HRR: 95% CI, 0.973: 0.960-0.987, p<0.001) were significantly and independently associated with an increased time-to-claim closure. Shorter time to claim closure was associated with having no legal involvement (HRR: 95% CI, 1.911: 1.169-3.123, p=0.009); and, not having a prior claim for compensation (HRR: 95% CI, 1.523: 1.062-2.198, p=0.022). CONCLUSIONS: Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants.
Authors: Sohail M Mulla; Sun Makosso-Kallyth; Nathalie St-Hilaire; Katrena Munsch; Peter B Gove; Diane Heels-Ansdell; Gordon H Guyatt; Jason W Busse Journal: CMAJ Open Date: 2017-02-07
Authors: Bamini Gopinath; Nieke A Elbers; Jagnoor Jagnoor; Ian A Harris; Michael Nicholas; Petrina Casey; Fiona Blyth; Christopher G Maher; Ian D Cameron Journal: BMC Public Health Date: 2016-05-20 Impact factor: 3.295
Authors: Aila Nica Bandong; Andrew Leaver; Martin Mackey; Rodney Ingram; Samantha Shearman; Christen Chan; Ian D Cameron; Niamh Moloney; Rebecca Mitchell; Eoin Doyle; Emma Leyten; Trudy Rebbeck Journal: BMC Health Serv Res Date: 2018-08-08 Impact factor: 2.655