Is compensation "bad for health"? A systematic meta-review

Spearing, Natalie M. and Connelly, Luke B. (2011) Is compensation "bad for health"? A systematic meta-review. Injury, 42 1: 15-24. doi:10.1016/j.injury.2009.12.009

Author Spearing, Natalie M.
Connelly, Luke B.
Title Is compensation "bad for health"? A systematic meta-review
Journal name Injury   Check publisher's open access policy
ISSN 0020-1383
Publication date 2011-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.injury.2009.12.009
Open Access Status
Volume 42
Issue 1
Start page 15
End page 24
Total pages 10
Place of publication Oxford, United Kingdom
Publisher Elsevier Science
Collection year 2011
Language eng
Formatted abstract
There is a common perception that injury compensation has a negative impact on health status, and systematic reviews supporting this thesis have been used to influence policy and practice decisions. This study evaluates the quality of the empirical evidence of a negative correlation between injury compensation and health outcomes, based on systematic reviews involving both veri. able and non-veri. able injuries.


Systematic meta-review (a "review of reviews'').

Data sources:
PubMED, CINAHL, EMBASE, PEDro, PsycInfo, EconLit, Lexis, ABI/INFORM, The Cochrane Library, and the AHRQ EPC were searched from the date of their inception to August 2008, and hand searches were conducted.

Review methods:
Selection criteria were established a priori. Included systematic reviews examined the impact of compensation on health, involved adults, were published in English and used a range of outcome measures. Two investigators independently applied standard instruments to evaluate the methodological quality of the included reviews. Data on compensation scheme design (i.e., the intervention) and outcome measures were also extracted.

Eleven systematic reviews involving veri. able and non-veri. able injuries met the inclusion criteria. Nine reviews reported an association between compensation and poor health outcomes. All of them were affected by the generally low quality of the primary (observational) research in this field, the heterogeneous nature of compensation laws (schemes) and legal processes for seeking compensation, and the difficulties in measuring compensation in relation to health.


Notwithstanding the limitations of the research in this field, one higher quality review examining a single compensation process and relying on primary studies using health outcome (rather than proxy) measures found strong evidence of no association between litigation and poor health following whiplash, challenging the general belief that legal processes have a negative impact on health status. Moves to alter scheme design and limit access to compensation on the basis that it is "bad for health'' are therefore premature, as evidence of such an association is unclear. (C) 2009 Elsevier Ltd. All rights reserved.
Keyword Compensation
Systematic review
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2011 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
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Created: Sun, 27 Jun 2010, 00:06:56 EST