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评估一项基于人群的复杂伤害索赔管理干预措施以改善伤害结局:研究方案。

Evaluation of a complex, population-based injury claims management intervention for improving injury outcomes: study protocol.

作者信息

Collie Alex, Gabbe Belinda, Fitzharris Michael

机构信息

Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

出版信息

BMJ Open. 2015 May 12;5(5):e006900. doi: 10.1136/bmjopen-2014-006900.

Abstract

INTRODUCTION

Injuries resulting from road traffic crashes are a substantial cause of disability and death worldwide. Injured persons receiving compensation have poorer recovery and return to work than those with non-compensable injury. Case or claims management is a critical component of injury compensation systems, and there is now evidence that claims management can have powerful positive impacts on recovery, but can also impede recovery or exacerbate mental health concerns in some injured people. This study seeks to evaluate the impact of a population-based injury claims management intervention in the State of Victoria, Australia, on the health of those injured in motor vehicle crashes, their experience of the compensation process, and the financial viability of the compensation system.

METHODS AND ANALYSIS

Evaluation of this complex intervention involves a series of linked but stand-alone research projects to assess the anticipated process changes, impacts and outcomes of the intervention over a 5-year time frame. Linkage and analysis of routine administrative and health system data is supplemented with a series of primary studies collecting new information. Additionally, a series of 'action' research projects will be undertaken to inform the implementation of the intervention. A program logic model designed by the state government Transport Accident Commission in conjunction with the research team provides the evaluation framework.

ETHICS AND DISSEMINATION

Relatively few studies have comprehensively examined the impact of compensation system processes on the health of injured persons, their satisfaction with systems processes, and impacts on the financial performance of the compensation scheme itself. The wholesale, population-based transformation of an injury claims management model is a rare opportunity to document impacts of system-level policy change on outcomes of injured persons. Findings will contribute to the evidence base of information on the public health effects of injury claims management policy and practice.

摘要

引言

道路交通事故造成的伤害是全球残疾和死亡的一个重要原因。获得赔偿的伤者比未获得赔偿的伤者康复情况更差,重返工作岗位的时间也更晚。案件或索赔管理是伤害赔偿系统的一个关键组成部分,现在有证据表明,索赔管理可以对康复产生强大的积极影响,但也可能阻碍某些伤者的康复或加剧其心理健康问题。本研究旨在评估澳大利亚维多利亚州一项基于人群的伤害索赔管理干预措施对机动车事故伤者健康、他们的赔偿过程体验以及赔偿系统财务可行性的影响。

方法与分析

对这一复杂干预措施的评估涉及一系列相互关联但独立的研究项目,以评估该干预措施在5年时间框架内预期的过程变化、影响和结果。常规行政和卫生系统数据的关联与分析辅以一系列收集新信息的初步研究。此外,还将开展一系列“行动”研究项目,为干预措施的实施提供信息。由州政府交通事故委员会与研究团队共同设计的项目逻辑模型提供了评估框架。

伦理与传播

相对较少的研究全面考察了赔偿系统流程对伤者健康、他们对系统流程的满意度以及对赔偿计划本身财务绩效的影响。对伤害索赔管理模式进行全面的、基于人群的转变,是记录系统层面政策变化对伤者结果影响的难得机会。研究结果将有助于丰富关于伤害索赔管理政策和实践对公共卫生影响的信息证据基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a65f/4431133/fbd9b37e1667/bmjopen2014006900f01.jpg

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