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雪上加霜:一项前瞻性队列研究,调查在严重损伤后 24 个月内随后的损伤索赔情况。

Injury upon injury: a prospective cohort study examining subsequent injury claims in the 24 months following a substantial injury.

机构信息

Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.

Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.

出版信息

Inj Prev. 2018 Dec;24(6):437-444. doi: 10.1136/injuryprev-2017-042467. Epub 2017 Oct 6.

Abstract

OBJECTIVES

This study examines subsequent injuries reported to the Accident Compensation Corporation (ACC), New Zealand's universal no-fault injury insurer, in the 24 months following an ACC entitlement claim injury event. Specific aims were to determine the: (1) 12 and 24 month cumulative incidence of at least one ACC-reported subsequent injury (ACC-SUBS-Inj), (2) characteristics of participants with and without ACC-SUBS-Inj, (3) frequency of ACC-SUBS-Inj, (4) time periods in which people are at higher risk of ACC-SUBS-Inj and (5) types of ACC-SUBS-Inj.

METHODS

Interview data collected directly from participants in the Prospective Outcomes of Injury Study (POIS) were combined with ACC-SUBS-Inj data from ACC and hospital discharge datasets. A subsequent injury was defined as any injury event resulting in an ACC claim within 24 months following the injury event for which participants were recruited to POIS (the sentinel injury). All ACC-SUBS-Inj were included irrespective of whether they were the same as the sentinel injury or not.

RESULTS

Of 2856 participants, 58% (n=1653) experienced at least one ACC-SUBS-Inj in 24 months; 31% (n=888) had more than one ACC-SUBS-Inj. The time period of lowest risk of ACC-SUBS-Inj was the first 3 months following the sentinel injury event. Spine sprain/strain was the type of injury with the greatest number of ACC-SUBS-Inj claims per person.

CONCLUSIONS

More than half of those with an ACC entitlement claim injury incurred further injury events that resulted in a claim in the following 24 months. Greater understanding of these subsequent injury events provides an avenue for injury prevention.

摘要

目的

本研究考察了新西兰全民无过错伤害保险机构(ACC)在 ACC 赔偿权利索赔伤害事件发生后的 24 个月内向 ACC 报告的后续伤害。具体目的是确定:(1)至少有一次 ACC 报告的后续伤害(ACC-SUBS-Inj)的 12 个月和 24 个月累积发生率;(2)有和没有 ACC-SUBS-Inj 的参与者的特征;(3)ACC-SUBS-Inj 的频率;(4)人们处于更高风险的时间段;(5)ACC-SUBS-Inj 的类型。

方法

直接从伤害研究的前瞻性结果(POIS)的参与者那里收集访谈数据,并与 ACC 和医院出院数据集的 ACC-SUBS-Inj 数据相结合。后续伤害被定义为在参与者被招募到 POIS(哨兵伤害)后的 24 个月内,任何导致 ACC 索赔的伤害事件。所有的 ACC-SUBS-Inj 都被包括在内,无论它们是否与哨兵伤害相同。

结果

在 2856 名参与者中,58%(n=1653)在 24 个月内经历了至少一次 ACC-SUBS-Inj;31%(n=888)有不止一次 ACC-SUBS-Inj。ACC-SUBS-Inj 风险最低的时间段是哨兵伤害事件发生后的前 3 个月。脊柱扭伤/拉伤是导致 ACC-SUBS-Inj 索赔人数最多的伤害类型。

结论

超过一半的有 ACC 赔偿权利索赔伤害的人在接下来的 24 个月内又发生了其他伤害事件,导致了索赔。对这些后续伤害事件的进一步了解为预防伤害提供了一个途径。

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