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Research

The effect of compensation on health care utilisation in a trauma cohort

Ian A Harris, Darnel F Murgatroyd, Ian D Cameron, Jane M Young and Michael J Solomon
MJA 2009; 190 (11): 619-622
Abstract
Objective:

To determine whether there is an association between compensation factors and health care utilisation following major trauma.

Design and setting:

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

Participants:

Major trauma patients aged ≥ 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%).

Main outcome measure:

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 ≥ 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.

Conclusion:

Compensation-related factors are significant predictors of health care utilisation in a major trauma population.

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