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Su SY, Li YW, Wen FH, Yao CY, Wang JY. Associations among Health Status, Occupation, and Occupational Injuries or Diseases: A Multi-Level Analysis. Diagnostics (Basel) 2023; 13:diagnostics13030381. [PMID: 36766485 PMCID: PMC9914676 DOI: 10.3390/diagnostics13030381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The present study used a hierarchical generalized linear model to explore the effects of physical and mental health and occupational categories on occupational injuries and diseases. METHODS The data were obtained from the Registry for Beneficiaries of the 2002-2013 National Health Insurance Research Database. The benefit categories involved adults with occupational injuries and diseases. Six major occupational categories and 28 subcategories were used. The main analysis methods were binary logistic regression (BLR) and hierarchical generalized linear model (HGLM). RESULTS After adjustment for relevant factors, the three major occupation subcategories most likely to develop occupational injuries and diseases were Subcategory 12 "employees with fixed employers" of Category 1 "civil servants, employees in public or private schools, laborers, and self-employed workers"; Subcategory 2 "employees in private organizations" of Category 1; and "sangha and religionists" of Category 6 "other citizens." Conditions such as mental disorders and obesity increased the risk of occupational injuries and diseases. CONCLUSION A portion of the occupational categories had a higher risk of occupational injuries and diseases. Physical and mental health issues were significantly correlated with occupational injuries and diseases. To the authors' knowledge, this is the first study to use HGLM to analyze differences in occupational categories in Taiwan.
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Affiliation(s)
- Shu-Yuan Su
- Public Health, China Medical University, Taichung 406040, Taiwan
| | - Yu-Wen Li
- Department of Human Resource, Wu Feng Cheng Ching Hospital, Taichung 412031, Taiwan
| | - Fur-Hsing Wen
- School of Business, Soochow University, Taipei 100006, Taiwan
| | - Chi-Yu Yao
- Department of Psychiatry, An Nan Hospital, Tainan City 709204, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
- Correspondence: ; Tel.: +886-4-22053366 (ext. 6313)
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Huang S, Dipnall JF, Gabbe BJ, Giummarra MJ. Pain and mental health symptom patterns and treatment trajectories following road trauma: a registry-based cohort study. Disabil Rehabil 2022; 44:8029-8041. [PMID: 34871122 DOI: 10.1080/09638288.2021.2008526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE This study aimed to characterise recovery from pain and mental health symptoms, and identify whether treatment use facilitates recovery. METHODS Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry participants without neurotrauma who had transport injury claims with the Transport Accident Commission from 2007 to 2014 were included (n = 5908). Latent transition analysis of pain Numeric Rating Scale, SF-12, and EQ-5D-3L pain and mental health items from 6 to 12 months, and 12 to 24 months post-injury were used to identify symptom transitions. RESULTS Four transition groups were identified: transition to low problems by 12-months; transition to low problems at 24-months; stable low problems; and no transition from problems. Group-based trajectory modelling of pain and mental health treatments found three treatment trajectories: low/no treatment, a moderate treatment that declined to low treatment 3-12 months post-injury, and increasing treatment over time. Predictors of pain and mental health recovery transitions, identified using multinomial logistic regression, were primarily found to be non-modifiable socioeconomic and health-related characteristics (e.g., higher education, working pre-injury, and not having comorbidities), and low treatment trajectories. CONCLUSIONS Targeted and collaborative rehabilitation should be considered for people at risk of persistent pain or mental health symptoms to optimise their recovery, particularly patients with socioeconomic disadvantage.IMPLICATIONS FOR REHABILITATIONTwo-thirds of people experience pain and/or mental health within the first 24-months after hospitalization for road trauma, of whom only 6-7% recover by 12-months, and a further 6% recover by 24-months post-injury.There were three main trajectories of administrative records of treatments received in the first two years after injury: 76 and 83% had low treatment, 18 and 12% had moderate then declining treatment levels, and 6 and 5% had stable high treatment for pain or mental health, respectively.People who recovered from pain or mental health symptoms generally had lower treatment and higher socioeconomic position, highlighting that coordinated rehabilitation care should be prioritized for people living with socioeconomic disadvantage.
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Affiliation(s)
- Sherry Huang
- Institute for Social Neuroscience, ISN Psychology, Ivanhoe, Australia
| | - Joanna F Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, UK
| | - Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Australia
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Melita J G, Joanna F D, Alex C, Jennie P, Shanthi A, Belinda J G. An evaluation of the association between fault attribution and healthcare costs and trajectories in the first three years after transport injury. Injury 2021; 52:3309-3319. [PMID: 34593247 DOI: 10.1016/j.injury.2021.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/12/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND People with complex medical and psychosocial issues have high healthcare needs. This registry-based cohort study sought to quantify the association between external fault attribution, recorded during compensation claim lodgement, and the cost and patterns of healthcare utilisation. METHODS 6,144 survivors of transport-related major trauma between 1 July 2010 and 30 June 2016 were extracted from the Victorian State Trauma Registry (VSTR) and linked to treatment payments from the Transport Accident Commission (TAC). Associations between fault and healthcare costs were examined with Generalised Linear Regression. Healthcare trajectories were identified using Group-Based Multi-Trajectory Modelling and included medical treatments from a physician, or pain, mental health and physical therapy treatments for the first three years post-injury. Trajectories were validated against the EQ-5D-3L health status summary score using mixed linear regression. RESULTS While injury severity had the strongest association with healthcare use, people who attributed fault to another had 9% higher healthcare costs. Six multi-trajectory groups were identified: 36% had low treatments over time; 25% had a rapid decline from high medical and physical therapy by 12-months; 12% had moderate to high medical and physical therapy that declined by 2-3 years; 11% had a gradual decline in medical treatment, an early increase in physical therapy but low pain and mental health treatment; 8% had high or increasing medical and physical therapy, moderate mental health therapy and low pain treatment; and 7% had moderate-high treatment across all domains. All groups had poorer health status compared with the group with low treatment levels, and people who attributed fault to another had higher risk of following trajectories with higher levels of treatment versus the low treatment group (beta=0.34, SE=0.12, p=0.01). CONCLUSION These findings highlight the need to provide pro-active multidisciplinary care coordination for people with complex needs after injury to better optimise recovery.
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Affiliation(s)
- Giummarra Melita J
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
| | - Dipnall Joanna F
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Collie Alex
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ponsford Jennie
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, VIC, Australia
| | - Ameratunga Shanthi
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand; Population Health Directorate, Counties Manukau District Health Board, South Auckland, New Zealand
| | - Gabbe Belinda J
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Health Data Research UK, Swansea University Medical School, Singleton Park, Swansea University, Swansea, Wales, UK, SA2 8PP
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Lane TJ, Berecki-Gisolf J, Iles R, Smith PM, Collie A. The impact of long-term workers' compensation benefit cessation on welfare and health service use: protocol for a longitudinal controlled data linkage study. Int J Popul Data Sci 2021; 6:1419. [PMID: 34036182 PMCID: PMC8130798 DOI: 10.23889/ijpds.v6i1.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background In 2012, the Australian state of New South Wales passed legislation that reformed its workers’ compensation system. Section 39 introduced a five-year limit on income replacement, with the first affected group having their benefits cease in December 2017. There is limited evidence on how this will affect their healthcare service use and where they will go for financial support. Methods Multiple data sources will be linked: administrate workers’ compensation claims data from the State Insurance Regulatory Authority (SIRA), universal health insurance data from the Medical Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), state hospital and emergency department data, and social welfare data from the Department of Social Services’ Data Over Multiple Individual Occurrences (DOMINO). An estimated 4,125 injured workers had their benefits cease due to Section 39. These will form the exposure group who will be compared to 1) a similar group of workers’ compensation claimants who have had at least two years of compensated time off work but whose benefits did not cease due to Section 39; and 2) a community comparison group drawn from state hospital and emergency department records. An accredited third party will link the data, which will be accessible only via secure virtual machine. Initial analyses will compare the prevalence and incidence of service use across groups in both the year before and year after benefit cessation; the community control will be assigned the median benefit cessation date in lieu of an actual date. To estimate the impact of benefit cessation due to Section 39, we will conduct time series analysis of the prevalence and incidence of service use. Discussion This study will provide much-needed evidence on the consequences of long-term benefit cessation, particularly on subsequent healthcare and welfare service use.
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Affiliation(s)
- Tyler J Lane
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Janneke Berecki-Gisolf
- Monash University Accident Research Centre (MUARC), Monash University, Clayton, Victoria, Australia
| | - Ross Iles
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter M Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Institute for Work and Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Nguyen TL, Baker KS, Ioannou L, Hassani-Mahmooei B, Gibson SJ, Collie A, Ponsford J, Cameron PA, Gabbe BJ, Giummarra MJ. Prognostic Role of Demographic, Injury and Claim Factors in Disabling Pain and Mental Health Conditions 12 Months after Compensable Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7320. [PMID: 33036417 PMCID: PMC7579145 DOI: 10.3390/ijerph17197320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/23/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
Identifying who might develop disabling pain or poor mental health after injury is a high priority so that healthcare providers can provide targeted preventive interventions. This retrospective cohort study aimed to identify predictors of disabling pain or probable mental health conditions at 12 months post-injury. Participants were recruited 12-months after admission to a major trauma service for a compensable transport or workplace injury (n = 157). Injury, compensation claim, health services and medication information were obtained from the Victorian Orthopaedic Trauma Outcome Registry, Victorian State Trauma Registry and Compensation Research Database. Participants completed questionnaires about pain, and mental health (anxiety, depression, posttraumatic stress disorder) at 12 months post-injury. One third had disabling pain, one third had at least one probable mental health condition and more than one in five had both disabling pain and a mental health condition at 12 months post-injury. Multivariable logistic regression found mental health treatment 3-6 months post-injury, persistent work disability and opioid use at 6-12 months predicted disabling pain at 12 months post-injury. The presence of opioid use at 3-6 months, work disability and psychotropic medications at 6-12 months predicted a mental health condition at 12 months post-injury. These factors could be used to identify at risk of developing disabling pain who could benefit from timely interventions to better manage both pain and mental health post-injury. Implications for healthcare and compensation system are discussed.
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Affiliation(s)
- Thi L. Nguyen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Katharine S. Baker
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, 27 Rainforest Walk, Clayton, VIC 3800, Australia; (K.S.B.); (J.P.)
| | - Liane Ioannou
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Behrooz Hassani-Mahmooei
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Stephen J. Gibson
- Caulfield Pain Management and Research Centre, Caulfield Hospital, 260–294 Kooyong Rd, Caulfield, VIC 3162, Australia;
| | - Alex Collie
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Jennie Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, 27 Rainforest Walk, Clayton, VIC 3800, Australia; (K.S.B.); (J.P.)
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, 89 Bridge Rd, Richmond, VIC 3121, Australia
| | - Peter A. Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Belinda J. Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
- Health Data Research UK, Swansea University Medical School, Swansea University, Wales, Sketty, Swansea SA2 8QA, UK
| | - Melita J. Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
- Caulfield Pain Management and Research Centre, Caulfield Hospital, 260–294 Kooyong Rd, Caulfield, VIC 3162, Australia;
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Abstract
Medicine use as part of multimodal management for whiplash-associated disorders (WAD) is common: neck pain is the cardinal symptom, mental health conditions are common, and some individuals may have neurological signs and symptoms. Almost half of the individuals with WAD have ongoing pain and disability. However, medicine use during acute and chronic recovery periods for WAD management is unknown. We analysed medicine use during acute (<12 weeks) and chronic (12 weeks to 2 years) postinjury periods in adults claiming compensation for WAD in the no-fault jurisdiction of Victoria, Australia (n = 2871). Compared with males, females were more likely to have only nonopioid analgesic and/or NSAID claims during the acute postinjury period (odds ratio = 1.35 [95% confidence interval: 1.08-1.68]). However, high medicine use was more likely in males (1.39 [1.16-1.67]), middle-aged claimants (35-44 years) (1.74 [1.12-2.56]), and claimants with a common law claim (2.96 [2.38-3.68]). During both acute and chronic postinjury periods, over half of the pharmaceutical claimants were prescribed NSAIDs and weak opioid medicines, and over one quarter were prescribed benzodiazepines. Antidepressant use was high during the chronic period. The proportion of strong opioid claimants quadrupled between 2000/2001 (5.5%) and 2012/2013 (23.4%). Opioid consumption, expressed as oral morphine equivalent, was double in males than in females (z = -5.4, P < 0.001), and higher in middle-aged than in younger or older claimants (χ = 13.9, P < 0.001). The high opioid, benzodiazepine, and antidepressant medicine use in this study is concerning and highlights the need for pharmaceutical approaches that balance pain management while minimising risk.
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Giummarra MJ, Black O, Smith P, Collie A, Hassani-Mahmooei B, Arnold CA, Gong J, Gabbe BJ. A population-based study of treated mental health and persistent pain conditions after transport injury. Injury 2018; 49:1787-1795. [PMID: 30154021 DOI: 10.1016/j.injury.2018.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Persistent pain and mental health conditions often co-occur after injury, cause enormous disability, reduce social and economic participation, and increase long-term healthcare costs. This study aimed to characterise the incidence, profile and healthcare cost implications for people who have a treated mental health condition, persistent pain, or both conditions, after compensable transport injury. METHODS The study comprised a population cohort of people who sustained a transport injury (n = 74,217) between 2008 to 2013 and had an accepted claim in the no-fault transport compensation system in Victoria, Australia. Data included demographic and injury characteristics, and payments for treatment and income replacement from the Compensation Research Database. Treated conditions were identified from 3 to 24-months postinjury using payment-based criteria developed with clinical and compensation system experts. Criteria included medications for pain, anxiety, depression or psychosis, and services from physiotherapists, psychologists, psychiatrists, and pain specialists. The data were analysed with Cox Proportional Hazards regression to examine rates of treated conditions, and general linear regression to estimate 24 month healthcare costs. RESULTS Overall, the incidence of treated mental health conditions (n = 2459, 3.3%) and persistent pain (n = 4708, 6.3%) was low, but rates were higher in those who were female, middle aged (35-64 years), living in metropolitan areas or neighbourhoods with high socioeconomic disadvantage, and for people who had a more severe injury. Healthcare costs totalled more than $A707 M, and people with one or both conditions (7.7%) had healthcare costs up to 7-fold higher (adjusting for demographic and injury characteristics) in the first 24 months postinjury than those with neither condition. CONCLUSIONS The incidence of treated mental health and persistent pain conditions was low, but the total healthcare costs for people with treated conditions were markedly higher than for people without either treated condition. While linkage with other public records of treatment was not possible, the true incidence of treated conditions is likely to be even higher than that found in this study. The present findings can be used to prioritise the implementation of timely access to treatment to prevent or attenuate the severity of pain and mental health conditions after transport injury.
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Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia; Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia.
| | - Oliver Black
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Smith
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Institute for Work and Health, Toronto, Ontario, Canada
| | - Alex Collie
- Insurance, Work and Health Group, Monash University, Melbourne, Victoria, Australia
| | | | - Carolyn A Arnold
- Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia; Academic Board of Anaesthesia & Perioperative Medicine, School of Medicine Nursing & Health Sciences, Monash University, Clayton, VIC, Australia
| | - Jennifer Gong
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Belinda J Gabbe
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Farr Institute, Swansea University Medical School, Swansea University, Wales, UK
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Nikles J, Yelland M, Bayram C, Miller G, Sterling M. Management of Whiplash Associated Disorders in Australian general practice. BMC Musculoskelet Disord 2017; 18:551. [PMID: 29284446 PMCID: PMC5747169 DOI: 10.1186/s12891-017-1899-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/08/2017] [Indexed: 11/27/2022] Open
Abstract
Background Whiplash Associated Disorders (WAD) are common and costly, and are usually managed initially by general practitioners (GPs). How GPs manage WAD is largely unstudied, though there are clinical guidelines. Our aim was to ascertain the rate of management (percentage of encounters) of WAD among patients attending Australian general practice, and to review management of these problems, including imaging, medications and other treatments. Methods We analysed data from 2013 to 2016 collected by different random samples of approximately 1000 general practitioners (GPs) per year. Each GP collected data about 100 consecutive consultations for BEACH (Bettering the Evaluation and Care of Health), an Australian national study of general practice encounters. Main outcome measures were: the proportion of encounters involving management of WAD; management including imaging, medications and other treatments given; appropriateness of treatment assessed against published clinical guidelines. Results Of 291,100 encounters from 2919 GP participants (a nationally representative sample), WAD were managed at 137 encounters by 124 GPs (0.047%). Management rates were 0.050% (females) and 0.043% (males). For 63 new cases (46%), 19 imaging tests were ordered, most commonly neck/cervical spine x-ray (52.6% of tests for new cases), and neck/cervical spine CT scan (31.6%). One or more medications were prescribed/supplied for 53.3% of WAD. NSAIDs (11.7 per 100 WAD problems) and compound analgesics containing paracetamol and opioids (10.2 per 100 WAD problems) were the commonest medications used by GPs overall. Paracetamol alone was used in 8 per 100 WAD problems. The most frequent clinical/procedural treatments for WAD were physical medicine/rehabilitation (16.1 per 100 WAD problems), counselling (6.6), and general advice/education (5.8). Conclusions GPs refer about 30% of new cases for imaging (possibly overutilising imaging), and prescribe a range of drugs, approximately 22% of which are outside clinical guidelines. These findings suggest a need for further education of GPs, including indications for imaging after whiplash injury, identification of those more likely to develop chronic WAD, and medication management guidelines. WAD carry a large personal and economic burden, so the impact of improvements in GP management is potentially significant.
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Affiliation(s)
- Jane Nikles
- RECOVER Injury Research Centre NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland, Herston, Australia.
| | - Michael Yelland
- School of Medicine, Griffith University, Brisbane, Qld, Australia
| | - Clare Bayram
- Family Medicine Research Centre, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Graeme Miller
- Family Medicine Research Centre, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland, Herston, Australia
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Prang KH, Hassani-Mahmooei B, Collie A. Compensation Research Database: population-based injury data for surveillance, linkage and mining. BMC Res Notes 2016; 9:456. [PMID: 27716308 PMCID: PMC5045595 DOI: 10.1186/s13104-016-2255-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compensation health research aims to study the influence of compensation systems, processes and practices on health and health-related outcomes. In many jurisdictions, injury compensation authorities collect substantial volumes of case and service level data for the purpose of administering the compensation system. An important secondary use of such data is research and analysis to explore interactions between individuals and organisations in compensation systems, and between compensation and other systems including healthcare and legal systems, in order to understand the role of compensation processes in injury recovery. RESULTS The Compensation Research Database (CRD) established at the Institute for Safety Compensation and Recovery Research at Monash University, holds over 20 years of population-based data for transport and workplace injury in the state of Victoria, Australia. The CRD is unique in that it is held independently, at arm's length from the compensation authorities that collect the data, and its primary purpose is to support research and analyses to develop new insights into system and individual level outcomes. This paper describes the core elements of the database including the design, process and type of information collected. We review some of the research findings that have been published using the CRD, and describe the ongoing program of research utilising the database. CONCLUSIONS The CRD is a unique administrative database that supports research into compensation health, with the objective of improving understanding of the interaction between injury compensation systems and injury recovery. The availability of the CRD for independent research is leading to substantial advancements in the compensation health research field and in related areas.
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Affiliation(s)
- Khic-Houy Prang
- Institute for Safety, Compensation and Recovery Research, Monash University, Level 18, 222 Exhibition Street, Melbourne, VIC, 3000, Australia. .,Monash University Accident Research Centre, Monash University, Clayton, VIC, 3800, Australia.
| | - Behrooz Hassani-Mahmooei
- Institute for Safety, Compensation and Recovery Research, Monash University, Level 18, 222 Exhibition Street, Melbourne, VIC, 3000, Australia
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Level 18, 222 Exhibition Street, Melbourne, VIC, 3000, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
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