Predictors of severe or multiple subsequent injuries over 24 months among an already-injured cohort in New Zealand
Section snippets
Background
Injuries comprise 10% of the global disability burden [1], with multiple injury events sustained over time contributing to this burden. The Accident Compensation Corporation (ACC), New Zealand's universal injury insurer, receives approximately 1.95 million claims per year [2], a rate of about 400 claims per 1000 people. In the Subsequent Injury Study (SInS) [3], 58% of 2856 participants reported at least one subsequent injury event to ACC in the 24 months following an ACC entitlement claim (a
Methods
The SInS protocol has been published previously [22]. In brief, SInS combined three sources of data. Firstly, self-reported data from participant interviews undertaken approximately three months following an ACC entitlement claim injury event (the ‘sentinel’ injury) as part of the earlier POIS [23,24] Secondly, ACC claims related to participants’ sentinel injury, as well as for subsequent injury events in the following 24 months, and thirdly, the National Minimum Data Set (NMDS) of hospital
Results
In the 24 months following their sentinel injury event, 589 (21%) of 2856 participants had ≥1 severe ACC-SI (NISS≥4) (Outcome 1) and 888 (31%) had ≥2 ACC-SI regardless of severity (Outcome 2). No ACC-SI events were reported by 1203 (42%) participants. Analyses for Outcome 1 are therefore restricted to 1792 participants (1203 participants with no ACC-SI, and 589 with the outcome of interest). Analyses for Outcome 2 are restricted to 2091 participants (1203 with no ACC-SI and 888 participants
Discussion
People who present for treatment with healthcare providers following an injury are a readily identifiable group that could benefit from intervention strategies that may prevent subsequent injury events. In order to understand how best to target interventions it is necessary to understand the characteristics that increase the risk of subsequent injuries, and who may benefit from targeted injury prevention interventions. This paper has examined predictors of severe subsequent injury and multiple
Conclusions
Factors identified in this study may be useful indicators to aid healthcare providers and policy makers identify people at increased risk of severe or multiple subsequent injuries who may benefit from targeted injury prevention strategies or interventions. Although the ACC system is unique worldwide, the predictors of subsequent injury identified here are likely to be generalisable to people experiencing a wide range of sentinel and subsequent injury types including both hospitalisation and
Data sharing statement
Due to ethical constraints the data cannot be shared but anyone interested in pursuing collaborative research should contact [email protected].
Funding
The Subsequent Injury Study was funded by the Health Research Council of New Zealand (2015-2017; 15/091). The Prospective Outcomes of Injury Study was funded by the Health Research Council of New Zealand (2007-2013; 10/052) and co-funded by the Accident Compensation Corporation, New Zealand (2007-2010). The views and conclusions in the article are the authors and may not represent those of the funders.
CRediT authorship contribution statement
Helen Harcombe: Conceptualization, Visualization, Formal analysis, Data curation, Writing - original draft, Writing - review & editing. Gabrielle Davie: Conceptualization, Visualization, Data curation, Writing - review & editing. Emma Wyeth: Conceptualization, Visualization, Writing - review & editing. Shanthi Ameratunga: Visualization, Writing - review & editing. Denise Powell: Visualization, Writing - review & editing. Sarah Derrett: Conceptualization, Visualization, Data curation, Writing -
Declaration of Competing Interest
None.
Acknowledgments
The authors are grateful to the study participants for sharing their information.
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