The relationship between compensable status and long-term patient outcomes following orthopedic trauma

Objective: To determine the relationship between compensable status in a "no-fault" compensation scheme and long-term outcomes after orthopaedic trauma. Design and setting: Prospective cohort study within two adult Level 1 trauma centres in Victoria, Australia. Participants: Blunt trauma patients aged 18-64 years, admitted between September 2003 and August 2004 with orthopaedic injuries and funded by the no-fault compensation scheme for transport-related injury, or deemed non-compensable. Main outcome measures: 12-item Short Form Health Survey (SF-12) and return to work or study at 12 months after injury. Results: Of 1033 eligible patients, 707 (68.8%) provided follow-up data; 450 compensable and 247 non-compensable patients completed the study. After adjusting for differences across the groups (age, injury severity, head injury status, injury group, and discharge destination) using multivariate analyses, compensable patients were more likely than non-compensable patients to report moderate to severe disability at follow-up for the physical (adjusted odds ratio [AOR], 2.0; 95% CI, 1.3-2.9), and mental (AOR, 1.6; 95% CI, 1.1-2.5) summary scores of the SF-12. Compensable patients were less likely than non-compensable patients to have returned to work or study, even after adjusting for injury severity, age, head injury status and discharge destination (AOR, 0.6; 95% CI, 0.3-0.9). Conclusions; Patients covered by the no-fault compensation system for transport-related injuries in Victoria had worse outcomes than non-compensable patients.