The Effect of Compensation on General Health in Patients Sustaining Fractures in Motor Vehicle Trauma

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Objectives:The receipt or pursuit of compensation after injury has been associated with poor outcomes. This study aims to determine the association between compensation-related factors and general health in patients with fractures sustained in motor vehicle trauma.Design:Prospective survey.Setting:Metropolitan trauma centers.Patients/Participants:The study population was patients aged 18 years and older, presenting acutely with at least one fracture involving the long bones, pelvis, patella, talus, or calcaneus, resulting from motor vehicle trauma, and presenting acutely to 1 of 15 hospitals.Intervention:Patients were surveyed on admission to determine general factors, injury factors, and socioeconomic factors. Employment status at follow-up, compensation-related factors, and the main outcome variables were measured by survey at 6 months after injury. Multiple regression was used to determine significant predictors of outcome.Main Outcome Measurement:Physical and mental health summaries of the SF-36 General Health Survey.Results:Of the 306 patients recruited to the study, five were excluded, and completed questionnaires were available for 232 (75.8%). Claiming compensation was strongly associated with poor physical and mental health on univariate analysis, but it was not significant on multivariate analysis. The use of a lawyer in relation to the injury was the most significant variable associated with poor physical and mental health, after adjusting for other factors.Conclusions:Lawyer involvement, rather than pursuit of compensation, is associated with poor general health after fractures sustained in motor vehicle injuries. Although this may represent a direct effect, further research is recommended to determine the cause for this association.

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