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The effects of comorbidity and other factors on medical versus chiropractic care for back problems
1Department of Epidemiology, School of Public Health, University of California-Los Angeles 90095-1772, USA.
Study Design:
This study is a cross-sectional analysis of adults in the United States who reported at least one back-related visit to a health care professional during a 2-week reference period.
Objectives:
To estimate and compare the effects of comorbidity and other factors on self-reported use of medical and chiropractic care for back problems in the United States.
Summary Of Background Data:
Although back pain is the second most frequent primary symptom reported by patients seeking medical care and the most frequent primary symptom among chiropractic patients, there is a dearth of research on the predictors of chiropractic and medical care among back pain patients.
Methods:
Data from the 1989 National Health Interview Survey were used to perform a cross-sectional analysis of adults who sought care for a back-related condition. The primary predictor variables included comorbidity and associated disability, sociodemographic variables, and back-problem-related variables. Weighted logistic regression modeling was performed to estimate odds ratios adjusted for the effects of covariates.
Results:
Of the 4790 adults with reported back problems, 931 sought health care for their back condition during the 2-week reference period. Adults with disabling comorbidities and back-related restricted-activity days were relatively less likely to use chiropractic care than primary medical care. Those who were male, high-school educated, single, employed, and with more than nine doctor visits during the previous 12 months were relatively more likely to use chiropractic care than primary medical care.
Conclusions:
The presence of comorbidity-related or back-related disability, as well as other factors, affect the type of care sought for back conditions among adults in the United States.