Adoption and use of guidelines for whiplash: an audit of insurer and health professional practice in New South Wales, Australia

Table 5 Referral to specialists from a sample of WAD claims from four NSW CTP insurers

	N	Referred %	All files %
	N	N = 117	N = 288
Type of specialist
Surgical specialists	51	43.6	17.7
WAD specialists	24	20.5	8.3
Other specialists	18	15.4	6.3
More than one specialist	24	20.5	8.3
Referral source
General practitioner	62	53.0	21.5
Insurer	32	27.4	11.1
Solicitor	16	13.7	5.6
Medical specialist	5	4.3	1.7
Physiotherapist	2	1.7	0.7
Health professional justification
Opinion about diagnosis and management	63	32.5	21.9
Complexity and severity of the injury	8	6.8	2.8
Persistent pain, non-recovery	6	5.1	2.1
Surgical management, specialised procedures	2	1.7	0.7
Needs assessment	2	1.7	0.7
None cited	36	30.8	12.5
Indicated for WAD specialist but no referral made	55		19.1
Timeframe (days), median(IQR)
Time to request	89(158)
Outcome of specialist referral
Clarification of condition, assessment of impairment	26	22.2	9.0
Further imaging and tests	11	9.4	3.8
Continuation of current management	8	6.8	2.8
Pain management (medications, injections)	6	5.1	2.1
Referral to another health professional	5	4.3	1.7
Rehabilitation plan	2	1.7	0.7
Discontinuation of treatment	2	1.7	0.7
Return to work	2	1.7	0.7
No record	55	47.0	19.1

WAD whiplash associated disorder, NSW New South Wales, CTP compulsory third party, IQR interquartile range

ISSN: 1472-6963