The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash

J Clin Epidemiol. 2001 Mar;54(3):275-86. doi: 10.1016/s0895-4356(00)00319-x.

Abstract

Time-to-claim-closure is a common outcome in cohort studies of whiplash injuries. However, its relationship to health recovery is unknown. We investigated the association between neck pain, physical functioning, depressive symptomatology and time-to-claim-closure in a Saskatchewan cohort of 5398 whiplash claimants in 1994-1995. Participants were surveyed five times over 1 year. In 1995, the insurance system changed from tort to no-fault, eliminating compensation for pain and suffering. Under tort, a 10-point increase in pain reduced the claim-closure rate by 13-24% while a 10-point increase in physical functioning increased it by 17%. Depressive symptomatology reduced the claim-closure rate by 37%. Under no-fault, a 10-point increase in pain reduced the claim-closure rate by 18% while a 10-point increase in physical functioning increased it by 10-35%. The presence of depressive symptomatology reduced the claim-closure rate by 36%. The results suggests lower pain, better function and the absence of depressive symptoms are strongly associated with faster time-to-claim-closure and recovery after whiplash, independent of the insurance system.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic / economics
  • Adult
  • Canada
  • Depression / economics
  • Depression / etiology*
  • Female
  • Humans
  • Insurance Claim Review*
  • Insurance, Accident / legislation & jurisprudence
  • Male
  • Middle Aged
  • Neck Pain / economics
  • Neck Pain / etiology*
  • Pain Measurement
  • Saskatchewan
  • Socioeconomic Factors
  • Whiplash Injuries / complications
  • Whiplash Injuries / economics*
  • Whiplash Injuries / physiopathology*