The relationship between compensable status and long-term patient outcomes following orthopedic trauma
The relationship between compensable status and long-term patient outcomes following orthopedic trauma
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DOI：
10.5694/j.1326-5377.2007.tb01108.x
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发表时间：
2007-07-02
影响因子：
11.4
通讯作者：
Richardson, Martin D.
中科院分区：
文献类型：
--
作者：
Gabbe, Belinda J.;Cameron, Peter A.;Richardson, Martin D.
目的：确定“无过错”赔偿计划中的可赔偿状态与骨科创伤后长期结果之间的关系。设计和背景：在澳大利亚维多利亚州两个成人一级创伤中心进行的前瞻性队列研究。参与者：年龄 18-64 岁的钝性创伤患者，2003 年 9 月至 2004 年 8 月期间因骨科受伤入院，并由运输相关伤害无过错赔偿计划资助，或被视为主要结局指标：12 项简短健康调查 (SF-12) 并在受伤后 12 个月返回工作或学习。结果：在 1033 名符合条件的患者中，707 名 (68.8%) 提供了随访数据； 450 名可补偿患者和 247 名不可补偿患者完成了这项研究。使用多变量分析调整各组之间的差异（年龄、受伤严重程度、头部受伤状态、受伤类别和出院目的地）后，可补偿患者比不可补偿患者更有可能在随访时报告身体（调整后比值比 [AOR]，2.0；95% CI，1.3-2.9）和精神（AOR，1.6；95% CI，1.1-2.5）中度至重度残疾。 SF-12 的总分。即使在调整伤害严重程度、年龄、头部受伤状况和出院目的地后，可赔偿患者返回工作或学习的可能性也低于不可赔偿患者（AOR，0.6；95% CI，0.3-0.9）。结论；维多利亚州交通相关伤害无过错赔偿制度覆盖的患者的预后比不可赔偿的患者更差。
Objective: To determine the relationship between compensable status in a "no-fault" compensation scheme and long-term outcomes after orthopaedic trauma.Design and setting: Prospective cohort study within two adult Level 1 trauma centres in Victoria, Australia.Participants: Blunt trauma patients aged 18-64 years, admitted between September 2003 and August 2004 with orthopaedic injuries and funded by the no-fault compensation scheme for transport-related injury, or deemed non-compensable.Main outcome measures: 12-item Short Form Health Survey (SF-12) and return to work or study at 12 months after injury.Results: Of 1033 eligible patients, 707 (68.8%) provided follow-up data; 450 compensable and 247 non-compensable patients completed the study. After adjusting for differences across the groups (age, injury severity, head injury status, injury group, and discharge destination) using multivariate analyses, compensable patients were more likely than non-compensable patients to report moderate to severe disability at follow-up for the physical (adjusted odds ratio [AOR], 2.0; 95% CI, 1.3-2.9), and mental (AOR, 1.6; 95% CI, 1.1-2.5) summary scores of the SF-12. Compensable patients were less likely than non-compensable patients to have returned to work or study, even after adjusting for injury severity, age, head injury status and discharge destination (AOR, 0.6; 95% CI, 0.3-0.9).Conclusions; Patients covered by the no-fault compensation system for transport-related injuries in Victoria had worse outcomes than non-compensable patients.