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SAMY SUISSA, MARC GIROUX, MARIE GERVAIS, PIERRE PROULX, CLAIRE DESBIENS, JAC DELANEY, JACQUELINE QUAIL, BRIAN STEVENS, and SALLY NIKOLAJ ABSTRACT. Methods. A clinical management model was implemented in 5 geographic regions of the Province of Quebec, Canada, in 7 hospitals and 19 clinics. A 2-group population-based parallel design was used to assess its effectiveness. All patients with a new whiplash injury seen in these 26 centers between March and September, 2001 were entered into the Whiplash Management Model (experimental group). A reference group included all subjects who had a whiplash injury during this same period but were not seen in these 26 intervention centers. All subjects were followed for up to a year. The outcome variables were time on compensation, time to file closure, and total direct costs. Results. A total of 288 patients with WAD were identified in the experimental group and 1,875 patients in the reference group. The rate of ending of compensation was significantly higher in patients who received the experimental treatment model than those receiving the reference treatment approach (rate ratio, RR: 3.2; 95% confidence interval, CI: 2.8-3.6). The rate of file closure was also significantly higher with the experimental treatment (RR: 1.5; 95% CI: 1.2-1.8). The average cost per patient was significantly reduced with the experimental intervention. Conclusion. A coordinated whiplash management approach can lead to earlier return to work and lower costs for patients who have sustained a whiplash injury. (J Rheumatol 2006;33:581-7)
Key Indexing Terms: MOTOR VEHICLE CRASH From the Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University Health Centre, Montreal; Régie de l'assurance maladie du Québec; Société de l'assurance automobile du Québec; Université Laval, Quebec City; Department of Medicine, McGill University, Montreal, Quebec; Millard Health Centre, Edmonton, Alberta, Canada. Supported by a grant from the Société de l'assurance automobile du Québec (SAAQ). Dr. Suissa is the recipient of a Distinguished Investigator award from the Canadian Institutes of Health Research (CIHR). S. Suissa, PhD, Division of Clinical Epidemiology, Royal Victoria Hospital; M. Giroux, MD, Régie de l'assurance maladie du Québec; M. Gervais, PhD, Société de l'assurance automobile du Québec, and Université Laval; P. Proulx, MD, Department of Medicine, McGill University; C. Desbiens, Société de l'assurance automobile du Québec; J.A.C. Delaney, MSc; J. Quail, MSc, Division of Clinical Epidemiology, Royal Victoria Hospital; B. Stevens, PhD; S. Nikolaj, PhD, Millard Health Centre. Address reprint requests to Dr. S. Suissa, Division of Clinical Epidemiology, Royal Victoria Hospital, 687 Pine Avenue West, R4.29, Montreal, Quebec, Canada, H3A 1A1. Accepted for publication September 19, 2005.
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