Use of lawyers linked to increased health care utilisation among trauma patients

A survey of trauma patients reported in the Medical Journal of Australia has found that compensation-related factors are significant predictors of health care utilisation.

Ian Harris, Professor of Orthopaedic Surgery and Director of the University of New South Wales’ South West Sydney Clinical School, and his colleagues approached patients on a hospital trauma database who had been admitted between 1 May 1999 and 30 April 2004. A total of 355 patients responded to the survey.

After examining a broad range of variables, the results showed a definite correlation between compensation and utilisation of health care.

“Most notably, we found a significantly higher utilisation rate among patients using a lawyer”. This remained true “after allowing for the effects of time since injury, other compensation factors, injury severity, demographic factors and socioeconomic factors”.

“The reason for this effect is uncertain.” The analysis “showed that use of a lawyer and claiming compensation both had a strong effect, but the effect of a compensation claim was not significant after allowing for use of a lawyer.”

“It is possible that patients with more severe conditions required more health care visits, and were more likely to have a complex claim … however, we did not find that injury severity was a significant predictor of health care utilisation.”

The results also showed that a longer time since injury and having a head injury were significantly associated with lower health care utilisation, whereas being unemployed and having a chronic illness were associated with higher health care utilisation.

Professor Harris said the study provided evidence showing both predisposing factors (such as age and chronic illness) and enabling factors (such as compensation) are significant predictors of health care utilisation.

^{The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.}

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