Health and return to work in the first two years following road traffic injury: a comparison of outcomes between compensation claimants in Victoria and New South Wales, Australia

Abstract Background: Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored the perspectives and factors associated with recovery and health-related quality of life following mild to moderate RTI in older age in New South Wales, Australia. Methods: A qualitative study using content analysis was undertaken. Participants aged 65 or more years were purposively selected from a larger inception cohort study of health outcomes following mild to moderate RTI conducted in New South Wales, Australia. Semi-structured interviews were undertaken at approximately 12 or 24 months post-injury. Content analysis was used to code and analyse the data, with methodological rigour obtained by double-coding and discussing findings to reach consensus. Results were reported using the consolidated criteria for reporting qualitative research (COREQ). Results: Nineteen participants were invited to participate in the study of which 12 completed interviews. Data saturation was reached at the twelfth interview. Recovery experiences were diverse. Five main themes were identified: recovery is regaining independence; injury and disability in older age; the burden of non-obvious disability; the importance of support; and positive personal approaches. Key facilitators of recovery were: regaining independence; support from family and friends; and positive personal approaches. Key barriers were: threats to independence; passive coping behaviours; non-obvious disabilities (chronic pain, psychological impacts); and reluctance to raise ongoing issues with General Practitioners. Threats to independence, especially not driving and self-care, appeared to have a more profound effect on recovery than physical functioning. Conclusion: Older people view injury as a threat to independent functioning. This is somewhat different to what younger people report. Regaining independence is key to older people’s recovery and health-related quality of life following RTI, and should be a key consideration for health professionals, services and supports working with this unique cohort. Greater efforts to help older people regain their independence following RTI are needed and can be facilitated by health professionals and appropriate service provision. Trial registration: Australia New Zealand clinical trial registry identification number ACTRN12613000889752.

Download Full-text

I’ve got to be independent’: views of older people on recovery following road traffic injury in New South Wales, Australia

BMC Public Health ◽

10.1186/s12889-020-09391-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Katherine Brown ◽

Ian D. Cameron ◽

Lisa Keay ◽

Ha Nguyen ◽

Lisa Dillon ◽

...

Keyword(s):

Older People ◽

Road Traffic ◽

New South ◽

New South Wales ◽

Road Traffic Injury ◽

Traffic Injury ◽

South Wales

Download Full-text

‘I’ve got to be independent’: Views of older people on recovery following road traffic injury in New South Wales, Australia

10.21203/rs.3.rs-18663/v3 ◽

2020 ◽

Author(s):

Katherine Brown ◽

Ian D Cameron ◽

Lisa Keay ◽

Ha Nguyen ◽

Lisa Dillon ◽

...

Keyword(s):

Older People ◽

Road Traffic ◽

New South ◽

New South Wales ◽

Road Traffic Injury ◽

Older Age ◽

Traffic Injury ◽

South Wales ◽

Related Quality ◽

Health Related

Abstract Background: Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored the perspectives and factors associated with recovery and health-related quality of life following mild to moderate RTI in older age in New South Wales, Australia.Methods: A qualitative study using content analysis was undertaken. Participants aged 65 or more years were purposively selected from a larger inception cohort study of health outcomes following mild to moderate RTI conducted in New South Wales, Australia. Semi-structured interviews were undertaken at approximately 12 or 24 months after injury. Content analysis was used to code and analyse the data, with methodological rigour obtained by double-coding and discussing findings to reach consensus. Results were reported using the consolidated criteria for reporting qualitative research (COREQ). Results: Nineteen participants were invited to participate in the study of which 12 completed interviews. Data saturation was reached at the twelfth interview. Recovery experiences were diverse. Five main themes were identified: recovery is regaining independence; injury and disability in older age; the burden of non-obvious disability; the importance of support; and positive personal approaches. Key facilitators of recovery were: regaining independence; support from family and friends; and positive personal approaches. Key barriers were: threats to independence; passive coping behaviours; non-obvious disabilities (chronic pain, psychological impacts); and for some, a reluctance to raise ongoing issues with General Practitioners. Threats to independence, especially not driving and self-care, appeared to have a more profound effect on recovery than physical functioning.Conclusion: Older people view injury as a threat to independent functioning. This is somewhat different to what younger people report. Regaining independence is key to older people’s recovery and health-related quality of life following RTI, and should be a key consideration for health professionals, services and supports working with this unique cohort. Greater efforts to help older people regain their independence following RTI are needed and can be facilitated by health professionals and appropriate service provision.

Download Full-text

Association between perception of fault for the crash and function, return to work and health status 1 year after road traffic injury: a registry-based cohort study

BMJ Open ◽

10.1136/bmjopen-2015-009907 ◽

2015 ◽

Vol 5 (11) ◽

pp. e009907 ◽

Cited By ~ 14

Author(s):

Belinda J Gabbe ◽

Pamela M Simpson ◽

Peter A Cameron ◽

Christina L Ekegren ◽

Elton R Edwards ◽

...

Keyword(s):

Cohort Study ◽

Health Status ◽

Return To Work ◽

Road Traffic ◽

Road Traffic Injury ◽

Traffic Injury ◽

And Function ◽

Work And Health

Download Full-text

ROAD TRAFFIC ACCIDENTS: REVIEWING THE EFFICACY OF ROAD SAFETY MEASURES IN NEW SOUTH WALES, AUSTRALIA

Disaster Management and Human Health Risk VI : Reducing Risk, Improving Outcomes ◽

10.2495/dman190031 ◽

2019 ◽

Author(s):

PETER J. KAVALAMTHARA ◽

SAJAN CYRIL ◽

YIYANG LIU ◽

VIVIENNE SAVERIMUTTU

Keyword(s):

Road Safety ◽

Traffic Accidents ◽

Road Traffic ◽

New South ◽

New South Wales ◽

Road Traffic Accidents ◽

Safety Measures ◽

South Wales

Download Full-text

Road traffic accidents in New South Wales, 1881-1991

Australian Economic History Review ◽

10.1111/aehr.342004 ◽

1994 ◽

Vol 34 (2) ◽

pp. 80-116 ◽

Cited By ~ 6

Author(s):

John William Knott

Keyword(s):

Traffic Accidents ◽

Road Traffic ◽

New South ◽

New South Wales ◽

Road Traffic Accidents ◽

South Wales

Download Full-text

Trajectories of sickness absence after road traffic injury: a Swedish register-based cohort study

BMJ Open ◽

10.1136/bmjopen-2019-031132 ◽

2019 ◽

Vol 9 (7) ◽

pp. e031132 ◽

Cited By ~ 1

Author(s):

Ritva Rissanen ◽

Yajun Liang ◽

Jette Moeller ◽

Alicia Nevriana ◽

Hans-Yngve Berg ◽

...

Keyword(s):

Cohort Study ◽

Return To Work ◽

Sickness Absence ◽

Injury Severity ◽

Outcome Measure ◽

Road Traffic ◽

Road Traffic Injury ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Traffic Injury

ObjectivesDespite much focus on the health impact of road traffic injury (RTI) on life, there is a lack of knowledge of the dynamic process of return to work following RTI and its related factors. The aim of this study was to identify longitudinal patterns of sickness absence (SA) following RTI, to examine the patterns’ interplay with health-related quality of life (HRQoL) and to determine if there are differences, regarding the patterns and interplay, according to injury severity.DesignA register-based prospective cohort study.SettingAdministrative data on RTI in Sweden from the Swedish Traffic Accident Data Acquisition System (STRADA) and Swedish Social Insurance data.ParticipantsIndividuals suffering an RTI (total n=4761) were identified in STRADA between 1 January 2007 and 31 December 2009. A total of 903 of these met the inclusion criteria for the current study and were included.Primary and secondary outcome measuresThe primary outcome measure was SA following RTI. The secondary outcome measure was HRQoL.ResultsThree distinct patterns of SA were identified; ‘Stable’, ‘Quick decrease’ and ‘Gradual decrease’. The patterns differed in the number of initial SA days and the rate of reduction of SA days. After 3 years, all three patterns had almost the same level of SA. Higher injury severity and a higher number of SA days had a negative interplay with HRQoL. Participants who initially had a higher number of SA days were more likely to report a low HRQoL, indicating that people with a slower return to work are more vulnerable.ConclusionThe study highlights the heterogeneity of return to work after an RTI. People with a more severe injury and slower pace of return to work seem to be more vulnerable with regards to HRQoL loss following RTI.

Download Full-text

A community-based survey of the koala Phascolarctos cinereus in the Lismore region of north-eastern New South Wales.

Australian Mammalogy ◽

10.1071/am03155 ◽

2003 ◽

Vol 25 (2) ◽

pp. 155 ◽

Cited By ~ 3

Author(s):

JM Harris ◽

RL Goldingay

Keyword(s):

Road Traffic ◽

New South ◽

New South Wales ◽

Strong Support ◽

Management Plan ◽

Tree Planting ◽

Community Based ◽

Phascolarctos Cinereus ◽

South Wales ◽

North Eastern

A community-based survey was undertaken in the Lismore Local Government Area (LGA) of north-eastern New South Wales to provide a basis for the development of a Shire-wide koala management plan. A questionnaire and maps were distributed to identify community attitudes towards P. cinereus conservation and management, as well as to document locations of sightings. There were 1121 surveys returned from 23,751 distributed (4.7% returned) across 18,000 ratepayers (6.2% response). Respondents indicated the frequency with which P. cinereus were seen in different suburbs, whether they had young or were sick, and provided 840 map-based records. Ten percent of respondents saw P. cinereus on at least a weekly basis, highlighting the importance of this LGA for the conservation of this species. More than 80% of respondents considered that roving dogs, land clearing, road traffic and housing development were serious threats to long-term P. cinereus survival. More than 90% of respondents supported restrictions on dogs, tree-planting programs, as well as planning activities to protect P. cinereus habitat while 85% approved of protection zones to control development within P. cinereus habitat. These results if representative of the entire community suggest strong support for the development of conservation options for P. cinereus. The study also confirms the usefulness of conducting such community-wide surveys for conspicuous threatened species.

Download Full-text

Rates, costs, return to work and reoperation following spinal surgery in a workers’ compensation cohort in New South Wales, 2010–2018: a cohort study using administrative data

BMC Health Services Research ◽

10.1186/s12913-021-06900-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

AM Lewin ◽

M Fearnside ◽

R Kuru ◽

BP Jonker ◽

JM Naylor ◽

...

Keyword(s):

Cohort Study ◽

Return To Work ◽

Spinal Surgery ◽

New South ◽

New South Wales ◽

Workers Compensation ◽

Post Surgery ◽

South Wales ◽

Surgery Rates ◽

Reoperation Rates

Abstract Background Internationally, elective spinal surgery rates in workers’ compensation populations are high, as are reoperation rates, while return-to-work rates following spinal surgery are low. Little information is available from Australia. The aim of this study was to describe the rates, costs, return to work and reoperation following elective spinal surgery in the workers’ compensation population in New South Wales (NSW), Australia. Methods This retrospective cohort study used administrative data from the State Insurance Regulatory Authority, the government organisation responsible for regulating and administering workers’ compensation insurance in NSW. These data cover all workers’ compensation-insured workers in New South Wales (over 3 million workers/year). We identified a cohort of insured workers who underwent elective spinal surgery (fusion or decompression) between January 1, 2010 and December 31, 2018. People who underwent surgery for spinal fracture or dislocation, or who had sustained a traumatic brain injury were excluded. The main outcome measures were annual spinal surgery rates, cost of the surgical episode, cumulative costs (surgical, hospital, medical and physical therapy) to 2 years post-surgery, and reoperation and return-to-work rates 2 years post-surgery. Results There were 9343 eligible claims (39.1 % fusion; 59.9 % decompression); claimants were predominantly male (75 %) with a mean age of 43 (range 18 to 75) years. Spinal surgery rates ranged from 15 to 29 surgeries per 100,000 workers per year, fell from 2011-12 to 2014-15 and rose thereafter. The average cost in Australian dollars for a surgical episode was $46,000 for a spinal fusion and $20,000 for a decompression. Two years post-fusion, only 19 % of people had returned to work at full capacity; 39 % after decompression. Nineteen percent of patients underwent additional spinal surgery within 2 years of the index surgery, to a maximum of 5 additional surgeries. Conclusion Rates of workers’ compensation-funded spinal surgery did not rise significantly during the study period, but reoperation rates are high and return-to-work rates are low in this population at 2 years post- surgery. In the context of the poor evidence base supporting lumbar fusion surgery, the high cost, increasing rates, and the increased likelihood of poor outcomes in the workers’ compensation population, we question the value of this procedure in this setting.

Download Full-text