A Population-Based Cohort Study
A Population-Based Cohort Study
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发表时间：
2003
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通讯作者：
J.David Cassidy-;Linda J. Carroll;Pierre Côté;Anita Berglund;Åke Nygren
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作者：
J.David Cassidy-;Linda J. Carroll;Pierre Côté;Anita Berglund;Åke Nygren
研究设计.进行了一项基于人群的发病率队列研究。Objective.测量保险赔偿制度改变前后碰撞相关腰痛的发病率和预后。背景数据总结。下背痛是一种常见且昂贵的职业伤害。它也会发生在交通冲突之后，但对这种情况下的频率和恢复知之甚少。方法. 1994年7月1日至1995年12月31日在萨斯喀彻温省形成了4473例腰痛损伤索赔的发病率队列。1995年1月1日，公共保险制度从侵权制度改为无过失制度，取消了对痛苦和苦难的赔偿。计算变更前后的索赔发生率和索赔结案时间。使用基线和随访数据建立预后模型。结果保险变更后，6个月的索赔发生率从每10万人256起下降到176起。索赔结案的中位时间从侵权索赔的505天下降到210天，在无过错期的第一个和第二个6个月内提出的索赔为216天。身体疼痛和身体功能的改善以及没有抑郁症状与更快的索赔关闭相关。高疼痛强度、女性、全职工作、注意力集中问题和律师在索赔过程中的早期参与延迟了索赔结束。结论.下背痛是一种常见的交通伤，恢复期长。其发病率和预后受多种因素的影响，包括补偿系统的类型。我们的研究表明，生物心理社会因素是重要的，在决定预后。[
Study Design. A population-based, incidence cohort study was conducted. Objective. To measure the incidence and prognosis for collision-related low back pain before and after a change in the insurance compensation system. Summary of Background Data. Low back pain is a common and costly occupational injury. It also occurs after traffic collisions, but less is known about its frequency and recovery in this setting. Methods. An incidence cohort of 4473 low back pain injury claims was formed between July 1, 1994 and December 31, 1995 in Saskatchewan. On January 1, 1995 the public insurance system changed from a tort system to a no-fault system, eliminating compensation for pain and suffering. The incidence of claims and the time to claim closure were calculated before and after this change. Prognostic models were built using baseline and follow-up data. Results. The 6-month incidence of claims decreased from 256 to 176 per 100,000 after the insurance change. The median time to claim closure dropped from 505 days for tort claims to 210 days and 216 days for claims made during the first and second 6 months of the no-fault period. Improvements in bodily pain and physical functioning and the absence of depressive symptoms were associated with faster claim closure. High pain intensity, female gender, full-time employment, concentration problems, and lawyer involvement early in the claim process delayed claim closure. Conclusions. Low back pain is a common traffic injury with a prolonged recovery. Its incidence and prognosis are affected by multiple factors, including the type of compensation system. Our study suggests that biopsychosocial factors are important in determining prognosis. [