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Injury upon injury: a prospective cohort study examining subsequent injury claims in the 24 months following a substantial injury
  1. Helen Harcombe1,
  2. Gabrielle Davie1,
  3. Emma Wyeth2,
  4. Ari Samaranayaka3,
  5. Sarah Derrett1
  1. 1Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  2. 2Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  3. 3Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  1. Correspondence to Dr Helen Harcombe, Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand; helen.harcombe{at}otago.ac.nz

Abstract

Objectives This study examines subsequent injuries reported to the Accident Compensation Corporation (ACC), New Zealand’s universal no-fault injury insurer, in the 24 months following an ACC entitlement claim injury event. Specific aims were to determine the: (1) 12 and 24 month cumulative incidence of at least one ACC-reported subsequent injury (ACC-SUBS-Inj), (2) characteristics of participants with and without ACC-SUBS-Inj, (3) frequency of ACC-SUBS-Inj, (4) time periods in which people are at higher risk of ACC-SUBS-Inj and (5) types of ACC-SUBS-Inj.

Methods Interview data collected directly from participants in the Prospective Outcomes of Injury Study (POIS) were combined with ACC-SUBS-Inj data from ACC and hospital discharge datasets. A subsequent injury was defined as any injury event resulting in an ACC claim within 24 months following the injury event for which participants were recruited to POIS (the sentinel injury). All ACC-SUBS-Inj were included irrespective of whether they were the same as the sentinel injury or not.

Results Of 2856 participants, 58% (n=1653) experienced at least one ACC-SUBS-Inj in 24 months; 31% (n=888) had more than one ACC-SUBS-Inj. The time period of lowest risk of ACC-SUBS-Inj was the first 3 months following the sentinel injury event. Spine sprain/strain was the type of injury with the greatest number of ACC-SUBS-Inj claims per person.

Conclusions More than half of those with an ACC entitlement claim injury incurred further injury events that resulted in a claim in the following 24 months. Greater understanding of these subsequent injury events provides an avenue for injury prevention.

  • cohort study
  • recidivism
  • descriptive epidemiology

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Footnotes

  • Contributors HH led the preparation of this paper and wrote the draft manuscript, HH, AS and GD undertook the analyses, SD and HH lead the Subsequent Injury Study project and SD leads the Prospective Outcomes of Injury Study project. All authors contributed to the design of the study, the interpretation of data and the writing and editing of the manuscript. All authors have read and approved the final manuscript.

  • Funding The Subsequent Injury Study was funded by the Health Research Council of New Zealand (2015-2017). The Prospective Outcomes of Injury Study was funded by the Health Research Council of New Zealand (2007-2013) and cofunded by the Accident Compensation Corporation, New Zealand (2007-2010). The views and conclusions in the article are of the authors and may not represent those of the funders.

  • Competing interests None declared.

  • Ethics approval New Zealand Health and Disability Multi-Region Ethics Committee (MEC/07/07/093).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Due to ethical constraints, the data cannot be shared but anyone interested in pursuing collaborative research should contact

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