Factors Influencing Social and Health Outcomes after Motor Vehicle

THE

Crash: Early Findings

Jagnoor Jagnoor, Ian D Cameron on behalf of FISH Study Investigators

1. Background and Aims

There is growing evidence that health and social outcomes following motor
vehicle crash injury are related to cognitive and emotional responses of the
injured individual, as well as relationships between the injured individual and
the systems they interact (including compensation processes). As most of this
evidence comes from other states in Australia or overseas, investigation is
therefore warranted to identify the key determinants of health and social
outcomes following injury in the context of the New South Wales motor accident
scheme.
The study aims to investigate the potential factors that may influence health and
social recovery, including pre- injury socio-demographic and health
characteristics, injury characteristics, utilisation of health services, and
compensation factors such as claims process, treatment, liability and fault, and
legal representation.
2. Methods

3. Results

In this inception cohort study, 2400 participants, aged 17 years or more, injured in a
motor vehicle crash in New South Wales will be identified though hospital emergency
departments, general and physiotherapy practitioners, police records and a government
insurance regulator database. Participants will be initially contacted through mail.
Baseline interviews will be conducted by telephone within 28 days of the injury and
participants will be followed up with interviews at 6, 12 and 24 months post-injury. Health
insurance and pharmaceutical prescription data will also be collected through Medicare
and Pharmaceutical Benefit Scheme data linkage for 1 years pre-injury and 2 years post
injury.
Table 1: Data collected at baseline and follow-up for the FISH study

The mean age of the participants (n=1058) recruited was 40 years and 67% were
males. At the time of injury, 77% of the participants were employed, working over 35
hours a week on average. The overall distribution by type of road user is presented in
Figure 1. Only 18% of the participants were current smokers and 42% consumed
alcohol on less than monthly basis. Perceived threat to life and threat to disability from
moderate to overwhelming was reported among 41% participants. Injury to lower limb
was the most common injury , 52%.
To date loss to follow up at 6 months is 2%. At 6 months (n=521) only 25% of the
participants had made a claim of any type for their injury. 5% had not returned to work,
whereas 23% had not returned to their usual social activities. Of the claimants 39.4%
had not returned to usual social activities versus 16.6% of non-claimants (p<0.0001). Of
the claimants 9.3% had not returned to work versus 4.0% of non-claimants (p=0.03)

Figure 2: Percent returning to work or usual social activities by claim

status

100
90
80

Percent

70
60
50
Claim lodged

40
30

No claim lodged

20
10
0
Return to work

Return to social activities

4. Discussion
The primary focus of this study is to examine associations and predictors for a range of
outcomes, requiring recruitment of a study population that exhibits heterogeneity in the
exposures of interest at baseline. The data on predictor variables will help identify high
risk groups and would lead to future research for targeted interventions focusing on the
modifiable factors. It is also hypothesised that compensation status is associated with
health outcomes, health care utilization, return to work and legal representation.

Significance

The results from the study will provide robust evidence for policy initiatives addressing
how compensation factors could improve health and social outcomes and scheme
efficiency and/or cost effectiveness of the NSW CTP scheme.

In addition circumstances of crash were also recorded as open verbatim at 6 months

Progress to date
Baseline
6 months follow up
1 year follow up

Interviews completed
1058
521
109

Refusals
378
12
0

References
Jagnoor J, Blyth F, Gabbe B, Derrett S, Boufous S, Dinh M, et al. Factors influencing social
and health outcomes after motor vehicle crash injury: an inception cohort study protocol.
BMC public health. 2014;14(1):199.