Rehabilitation Studies Unit, University of Sydney, PO Box 6, Ryde, NSW 1680, Australia.
BMC Public Health. 2012 Jan 16;12:36. doi: 10.1186/1471-2458-12-36.
Regaining good health and returning to work are important for people injured in road traffic crashes and for society. The handling of claims by insurance companies may play an important role in the rate at which health recovers and return to work is actually attained.
A novel approach towards claims handling for people injured in road traffic accidents was compared to the standard approach. The setting was a large insurance company (NRMA Insurance) in the state of New South Wales, Australia. The new approach involved communicating effectively with injured people, early intervention, screening for adverse prognostic factors and focusing on early return to work and usual activities. Demographic and injury data, health outcomes, return to work and usual activities were collected at baseline and 7 months post-injury.
Significant differences were found 7 months post-injury on 'caseness' of depression (p = 0.04), perceived health limitation on activities (p = 0.03), and self-reported return to usual activities (p = 0.01) with the intervention group scoring better. Baseline general health was a significant predictor for general health at 7 months (OR 11.6, 95% CI 2.7-49.4) and for return to usual activities (OR 4.6, 95% CI 2.3-9.3).
We found a few positive effects on health from a new claims handling method by a large insurance company. It may be most effective to target people who report low general health and low expectations for their health recovery when they file their claim.
对于道路交通事故中的受伤者和社会来说,恢复健康和重返工作岗位是很重要的。保险公司的理赔处理可能对健康恢复的速度和重返工作的实际程度起着重要作用。
将一种新颖的交通事故理赔处理方法与标准方法进行了比较。该研究地点为澳大利亚新南威尔士州的一家大型保险公司(NRMA 保险)。新方法包括与受伤者进行有效的沟通、早期干预、筛选不良预后因素,并注重早期重返工作和日常活动。在基线和受伤后 7 个月收集人口统计学和损伤数据、健康结果、重返工作和日常活动。
在受伤后 7 个月时,在抑郁的“病例数”(p = 0.04)、活动时感知的健康限制(p = 0.03)和自我报告的重返日常活动(p = 0.01)方面发现了显著差异,干预组的得分更好。基线一般健康是 7 个月时一般健康(OR 11.6,95%CI 2.7-49.4)和重返日常活动(OR 4.6,95%CI 2.3-9.3)的显著预测因素。
我们发现,一家大型保险公司的一种新的理赔处理方法对健康有一些积极影响。当人们提出索赔时,针对报告一般健康状况较低和对健康恢复期望较低的人群,可能效果最佳。