BMC Public Health | |
Changing insurance company claims handling processes improves some outcomes for people injured in road traffic crashes | |
Ian D Cameron1  Areen Kayaian1  Annelies De Wolf1  Frederieke Schaafsma1  | |
[1] Rehabilitation Studies Unit, University of Sydney, PO Box 6, Ryde, NSW 1680, Australia | |
关键词: Return to work; Health status; Rehabilitation; Claims handling; Road traffic injuries; | |
Others : 1163938 DOI : 10.1186/1471-2458-12-36 |
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received in 2011-06-28, accepted in 2012-01-16, 发布年份 2012 | |
【 摘 要 】
Background
Regaining good health and returning to work are important for people injured in road traffic crashes and for society. The handling of claims by insurance companies may play an important role in the rate at which health recovers and return to work is actually attained.
Methods
A novel approach towards claims handling for people injured in road traffic accidents was compared to the standard approach. The setting was a large insurance company (NRMA Insurance) in the state of New South Wales, Australia. The new approach involved communicating effectively with injured people, early intervention, screening for adverse prognostic factors and focusing on early return to work and usual activities. Demographic and injury data, health outcomes, return to work and usual activities were collected at baseline and 7 months post-injury.
Results
Significant differences were found 7 months post-injury on 'caseness' of depression (p = 0.04), perceived health limitation on activities (p = 0.03), and self-reported return to usual activities (p = 0.01) with the intervention group scoring better. Baseline general health was a significant predictor for general health at 7 months (OR 11.6, 95% CI 2.7-49.4) and for return to usual activities (OR 4.6, 95% CI 2.3-9.3).
Conclusion
We found a few positive effects on health from a new claims handling method by a large insurance company. It may be most effective to target people who report low general health and low expectations for their health recovery when they file their claim.
【 授权许可】
2012 Schaafsma et al; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150413123035986.pdf | 236KB | download | |
Figure 1. | 34KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Peden M, McGee K, Krug EE: Injury: A leading Cause of the Global Burden of Disease. Geneva: World Health Organization; 2002.
- [2]Binder LM, Rohling ML: Money matters: a meta-analytic review of the effects of financial incentives on recovery after closed-head injury. Am J Psychiatry 1996, 153:7-10.
- [3]Bryant B, Majou R, Lloyd-Bostock S: Compensation claims following road accidents: a six-year follow-up study. Med Sci Law 1997, 37:326-336.
- [4]Cassidy JD, Carroll LJ, Cote P, Lemstra M, Berglund A, Nygren A: Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Eng J Med 2000, 342:1179-1186.
- [5]Casey P, Feyer A, Cameron ID: Identifying predictors of early non-recovery in a compensation setting: the whiplash outcome study. Injury 2011, 42:25-32.
- [6]Motor Accidents Compensation Act. No 41. Australia: New South Wales; 1999.
- [7]Motor Authority Accidents. Treatment, Rehabilitation and Attendant Care Guidelines for Currently Licensed CTP Insurers (September 2006) Available from: http://www.maa.nsw.gov.au/default.aspx?MenuID=170 webcite
- [8]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psych Scand 1983, 67:361-370.
- [9]Zigmond AS, Snaith RP: The HADS: hospital anxiety and depression scale. Windsor: NFER Nelson; 1994.
- [10]Ware JE, Kozinski M, Turner-Bowker D, Gandek B: User's manual for the SF-12v2 Health Survey with a supplement documenting SF-12 Health Survey. Lincoln RI: QualyMetric Incorporated; 2002.
- [11]Crawford JR, Henry JD, Crombie C, Taylor EP: Brief report: normative data for the HADS from a large non-clinical sample. Brit J Clin Psy 2001, 40:429-434.
- [12]Ware JE, Snow KK, Kolinski M, Gandeck B: SF-36 Health survey manual and interpretation Guide. Boston: The Health Institute, New England Medical Centre; 1993.
- [13]Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health for the SF-36. J Health Economics 2002, 21:271-292.
- [14]Ozegovic D, Carroll L, Cassidy JD: Does expecting mean achieving? The association between expecting to return to work and recovery in whiplash associated disorders: a population-based prospective cohort study. Eur Spine J 2009, 18:893-899.
- [15]Turner J, Franklin G, Turk DC: Predictors of chronic disability in injured workers: a systematic literature synthesis. Am J Ind Med 2000, 38:707-722.
- [16]Lötters F, Franche RL, Hogg-Johnson S, Burdorf A, Pole JD: The prognostic value of depressive symptoms, fear-avoidance, and self-efficacy for duration of lost-time benefits in workers with musculoskeletal disorders. Occup Environ Med 2006, 63(12):794-801.
- [17]Dekker-Sanchez P, Hoving J, Sluiter J, et al.: Factors associated with long-term sickness leave in sick-listed employees; a systematic review. Occup Environ Med 2008, 65:153-157.
- [18]Littleton S, Cameron ID, Poustie S, Hughes D, Robinson B, Neeman T, et al.: The association of compensation on longer term health status for people with musculoskeletal injuries following road traffic crashes: emergency department inception cohort study. Injury 2010, 41(7):904-910.
- [19]Mayou R, Ehlers A, Bryant B: Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study. Behav Res and Ther 2002, 40(6):665-675.
- [20]Mayou R, Bryant B: Outcome 3 years after a road traffic accident. Psychol Med 2002, 32(4):671-675.
- [21]Buitenhuis J, de Jong PJ, Jaspers JPC, Groothoff JW: Work disability after whiplash. Spine 2009, 34:262-267.