Côté P, Hogg-Johnson S, Cassidy J D, Carroll L, Frank J W
Institute for Work & Health, #702-250 Bloor Street East, M4W 1E6, Toronto, ON, Canada.
J Clin Epidemiol. 2001 Mar;54(3):275-86. doi: 10.1016/s0895-4356(00)00319-x.
Time-to-claim-closure is a common outcome in cohort studies of whiplash injuries. However, its relationship to health recovery is unknown. We investigated the association between neck pain, physical functioning, depressive symptomatology and time-to-claim-closure in a Saskatchewan cohort of 5398 whiplash claimants in 1994-1995. Participants were surveyed five times over 1 year. In 1995, the insurance system changed from tort to no-fault, eliminating compensation for pain and suffering. Under tort, a 10-point increase in pain reduced the claim-closure rate by 13-24% while a 10-point increase in physical functioning increased it by 17%. Depressive symptomatology reduced the claim-closure rate by 37%. Under no-fault, a 10-point increase in pain reduced the claim-closure rate by 18% while a 10-point increase in physical functioning increased it by 10-35%. The presence of depressive symptomatology reduced the claim-closure rate by 36%. The results suggests lower pain, better function and the absence of depressive symptoms are strongly associated with faster time-to-claim-closure and recovery after whiplash, independent of the insurance system.
索赔结案时间是挥鞭伤队列研究中的一个常见结果。然而，它与健康恢复之间的关系尚不清楚。我们调查了1994年至1995年萨斯喀彻温省5398名挥鞭伤索赔者队列中颈部疼痛、身体功能、抑郁症状与索赔结案时间之间的关联。参与者在1年中接受了5次调查。1995年，保险制度从侵权责任转变为无过错责任，取消了对痛苦的赔偿。在侵权责任制度下，疼痛增加10分使索赔结案率降低13%至24%，而身体功能增加10分则使其提高17%。抑郁症状使索赔结案率降低37%。在无过错责任制度下，疼痛增加10分使索赔结案率降低18%，而身体功能增加10分则使其提高10%至35%。抑郁症状的存在使索赔结案率降低36%。结果表明，较低的疼痛、较好的功能以及没有抑郁症状与挥鞭伤后更快的索赔结案时间和恢复密切相关，且与保险制度无关。
