University of Copenhagen, Department of Economics, Øster Farimagsgade 5, Copenhagen K, Denmark.
J Health Econ. 2009 Sep;28(5):996-1011. doi: 10.1016/j.jhealeco.2009.06.013. Epub 2009 Jul 8.
A whiplash is a sudden acceleration-deceleration of the neck and head, typically associated with a rear-end car collision that may produce injuries in the soft tissue. Often there are no objective signs or symptoms of injury, and diagnosing lasting whiplash-associated disorders (WAD) is difficult, in particular for individuals with mild or moderate injuries. This leaves a scope for compensation-seeking behaviour. The medical literature disagrees on the importance of this explanation. In this paper we trace the long-term earnings of a group of Danish individuals with mild to moderate injuries claiming compensation for having permanently lost earnings capacity and investigate if they return to their full pre-whiplash earnings when the insurance claim has been assessed. We find that about half of the claimants, those not granted compensation, return to an earnings level comparable with their pre-whiplash earnings suggesting that these individuals do not have chronic WAD in the sense that their earnings capacity is reduced. The other half, those granted compensation, experience persistent reductions in earnings relative to the case where they had not been exposed to a whiplash, even when they have a strong financial incentive to not reduce earnings. This suggests that moderate injuries tend to be chronic, and that compensation-seeking behaviour is not the main explanation for this group. We find that claimants with chronic WADs used more health care in the year prior to the whiplash than claimants with non-chronic cases. This suggests that lower initial health capital increases the risk that a whiplash causes persistent WAD.
挥鞭样损伤是一种颈部和头部的突发性加速-减速，通常与追尾汽车碰撞有关，可能导致软组织损伤。通常没有受伤的客观迹象或症状，而且诊断持续的挥鞭样损伤相关障碍（WAD）很困难，特别是对于轻度或中度损伤的个体。这为寻求赔偿行为留下了空间。医学文献对这种解释的重要性存在分歧。在本文中，我们追踪了一组丹麦个体的长期收入，这些个体因永久性丧失收入能力而声称赔偿轻度至中度损伤，并调查了当保险索赔得到评估时，他们是否会恢复到完全的挥鞭前收入水平。我们发现，大约一半的索赔人，即那些未获得赔偿的人，恢复到与挥鞭前收入水平相当的收入水平，这表明这些个体没有慢性 WAD，即他们的收入能力没有降低。另一半，即那些获得赔偿的人，与未遭受挥鞭损伤的情况相比，收入持续下降，即使他们有强烈的经济动机不减少收入。这表明中度损伤往往是慢性的，而寻求赔偿行为不是该组的主要解释。我们发现，患有慢性 WAD 的索赔人在挥鞭前一年比患有非慢性病例的索赔人使用更多的医疗保健。这表明较低的初始健康资本增加了挥鞭导致持续 WAD 的风险。
