It is known that pre-injury health conditions can affect recovery after personal injury; however, if we want to maintain the financial viability of compensation schemes, we also need to understand how these conditions impact on the costs incurred by compensation bodies. These studies link compensation data with healthcare data to address these knowledge gaps.  

In academic language, the presence of an additional disease or disorder alongside a primary one is referred to as "co-morbidity." 

Pre-existing and ongoing chronic conditions  (such as diabetes and heart disease) are known to impact on injury recovery - and these conditions are becoming increasingly common in Australia, as we experience a progressive ageing of our population, and also face an upwards trend in obesity rates.

This increase in chronic conditions is likely to place pressure on compensation bodies. It is important to understand how these conditions will complicate compensation case management and impact on compensation costs, so that these bodies can effectively plan for the future.

Dr Janneke Berecki-Gisolf from the Monash Injury Research Institute (MIRI) led a series of projects to achieve this. The first project assessed this issue broadly, and its impact on both the TAC and WorkSafe. The second project focused more specifically on how these conditions (in isolation and combination) impact on TAC costs. 

Both projects used the same data: claims information linked with corresponding information from Medicare and Pharmaceutical Benefits Scheme (PBS).

Where to now?

The first project concluded with two reports featuring a range of recommendations. One was delivered to WorkSafe, and the other to the TAC.

A report from the second project was released publicly in July 2014.

Together, these projects confirm that pre-injury health (as indicated by Medicare and PBS data) has a relatively low impact on total TAC costs, with the exception of mental health. Specific diseases were also found to impact on specific cost areas. 

Some of the more specific findings are listed below:

  • Diabetes was associated with greater ambulance and hospital costs;
  • Cardiovascular disease was associated with greater medical and home service costs;
  • Back pain was associated with greater post-injury physiotherapy costs;
  • Surgery in the year prior to accident was associated with greater hospital and home service costs; and
  • Mental health history was associated with greater total claim costs.

Further building on these linkages, a new study is now under way in collaboration with WorkSafe. Its objective is to identify claimants at risk of adverse primary outcomes (claim duration, claim cost and health service use), secondary outcomes (persistent pain, secondary mental health, lawyer involvement and litigation, and repeat claims) and long-term outcomes (mortality and morbidity). 

This research will be used to help WorkSafe develop preventive measures and refine their ability to identify at-risk claimants early on in the claim journey.

These projects are examples of ISCRR expanding its data linkage capacity - and they lay the groundwork for further research endeavours in this area.