PSYCHOLOGICAL DISTRESS, PAIN AND INSURANCE CLAIMS NEGATIVELY AFFECT LONG-TERM HEALTH-RELATED QUALITY OF LIFE AFTER ROAD TRAFFIC INJURIES

Abstract

Objective: A prospective cohort study to investigate how injury and early post-injury psychosocial factors influence health outcomes 12 months after road traffic injury. Methods: Residents of New South Wales, Australia, with road traffic injury in the period 2013-16 were recruited. Explanatory factors were evaluated for outcomes over 12 months using 12-Item Short Form Survey (SF-12) Physical and Mental Component Scores (PCS and MCS). Path models and mediation analysis were used to examine the effect of injury severity and explanatory factors. Results: SF-12 PCS and MCS outcomes were poorer among participants with baseline psychological distress, for all injury severities (β coefficients -3.3 to -9.3, p < 0.0001). Baseline pain and psychological distress, and baseline PCS and MCS were each involved in indirect effects of injury severity on 12-month PCS and MCS. Injury severity, baseline PCS and MCS, and baseline psychological distress were also associated with the likelihood of a compulsory third-party insurance claim, and claiming was negatively associated with 12-month PCS and MCS outcomes (beta coefficients -0.22 and -0.14, respectively, for both, p < 0.01). Conclusion: Baseline factors, including pain, psychological distress and lodging a compulsory thirdparty insurance claim, negatively impact long-term physical and mental health status following road traffic injury, emphasizing the importance of early screening and intervention. Trial registration: Australia New Zealand Clinical trial registry identification number: ACTRN12613000889752.