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The effect of financial compensation on health outcomes following musculoskeletal injury: systematic review.

Murgatroyd DF, Casey PP, Cameron ID, Harris IA - PLoS ONE (2015)

Bottom Line: Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis.The results were mixed.No studies reported an association between compensation related factors and improved health outcomes.

View Article: PubMed Central - PubMed

Affiliation: John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia.

ABSTRACT
The effect of financial compensation on health outcomes following musculoskeletal injury requires further exploration because results to date are varied and controversial. This systematic review identifies compensation related factors associated with poorer health outcomes following musculoskeletal injury. Searches were conducted using electronic medical journal databases (Medline, CINAHL, Embase, Informit, Web of Science) for prospective studies published up to October 2012. Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis. Studies solely measuring return to work outcomes were excluded. Twenty nine articles were synthesised and then assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to determine evidence levels. The results were mixed. There was strong evidence of an association between compensation status and poorer psychological function; and legal representation and poorer physical function. There was moderate evidence of an association between compensation status and poorer physical function; and legal representation and poorer psychological function. There was limited evidence of an association between compensation status and increased pain. In seven studies the association depended on the outcome measured. No studies reported an association between compensation related factors and improved health outcomes. Further research is needed to find plausible reasons why compensation related factors are associated with poorer health following musculoskeletal injury.

No MeSH data available.


Related in: MedlinePlus

Retrieval of studies for the systematic review.
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pone.0117597.g001: Retrieval of studies for the systematic review.

Mentions: The search results and study selection process are illustrated in Fig. 1. Initially, 391 papers were independently reviewed by one investigator (DM, PC or IM). Full texts of the remaining 89 papers were independently examined by two investigators (DM, PC or IM). Reasons for exclusions are explained in S3 Appendix. In summary, they were: no predictive statistical model and/or multivariate analysis (n = 10); compensation related factor not measured as a predictor (n = 15); retrospective studies (n = 22); compensation only cohort without additional compensation related factor for comparison (n = 4); no validated health outcome (n = 6); and/or majority of cohort without musculoskeletal injuries (n = 2). Often ‘prospectively collected data’ were used but the study hypothesis and design were initiated post hoc after routine baseline data collection during the follow up period; these were by definition retrospective. Hand searching of reference lists and personal communication with experts minimised the potential for missing papers. Ultimately, 29 papers met the inclusion criteria.


The effect of financial compensation on health outcomes following musculoskeletal injury: systematic review.

Murgatroyd DF, Casey PP, Cameron ID, Harris IA - PLoS ONE (2015)

Retrieval of studies for the systematic review.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4334545&req=5

pone.0117597.g001: Retrieval of studies for the systematic review.
Mentions: The search results and study selection process are illustrated in Fig. 1. Initially, 391 papers were independently reviewed by one investigator (DM, PC or IM). Full texts of the remaining 89 papers were independently examined by two investigators (DM, PC or IM). Reasons for exclusions are explained in S3 Appendix. In summary, they were: no predictive statistical model and/or multivariate analysis (n = 10); compensation related factor not measured as a predictor (n = 15); retrospective studies (n = 22); compensation only cohort without additional compensation related factor for comparison (n = 4); no validated health outcome (n = 6); and/or majority of cohort without musculoskeletal injuries (n = 2). Often ‘prospectively collected data’ were used but the study hypothesis and design were initiated post hoc after routine baseline data collection during the follow up period; these were by definition retrospective. Hand searching of reference lists and personal communication with experts minimised the potential for missing papers. Ultimately, 29 papers met the inclusion criteria.

Bottom Line: Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis.The results were mixed.No studies reported an association between compensation related factors and improved health outcomes.

View Article: PubMed Central - PubMed

Affiliation: John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia.

ABSTRACT
The effect of financial compensation on health outcomes following musculoskeletal injury requires further exploration because results to date are varied and controversial. This systematic review identifies compensation related factors associated with poorer health outcomes following musculoskeletal injury. Searches were conducted using electronic medical journal databases (Medline, CINAHL, Embase, Informit, Web of Science) for prospective studies published up to October 2012. Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis. Studies solely measuring return to work outcomes were excluded. Twenty nine articles were synthesised and then assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to determine evidence levels. The results were mixed. There was strong evidence of an association between compensation status and poorer psychological function; and legal representation and poorer physical function. There was moderate evidence of an association between compensation status and poorer physical function; and legal representation and poorer psychological function. There was limited evidence of an association between compensation status and increased pain. In seven studies the association depended on the outcome measured. No studies reported an association between compensation related factors and improved health outcomes. Further research is needed to find plausible reasons why compensation related factors are associated with poorer health following musculoskeletal injury.

No MeSH data available.


Related in: MedlinePlus