Workers’ characteristics associated with the type of healthcare provider first seen for occupational back pain

BMC Musculoskeletal Disorders

Research Article

Clermont E. Dionne¹  Michèle Rivard²  Ivan Steenstra³  Sheilah Hogg-Johnson³  Marc-André Blanchette⁴ 

[1] Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, QC, Canada;Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec (CHUQ), Québec City, QC, Canada;Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada;Public Health Research Institute, University of Montreal, Montreal, QC, Canada;Institute for Work & Health, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;Public Health PhD Program, School of Public Health, University of Montreal, Montreal, QC, Canada;

关键词: Back pain;    Primary care;    Healthcare provider;    Medical doctor;    Chiropractic;    Physiotherapy;    Determinants;    Occupational health;   

DOI  :  10.1186/s12891-016-1298-y

 received in 2016-06-23, accepted in 2016-10-14,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundFew studies have compared the factors that drive patients’ decision to choose a chiropractor, physician or physiotherapist as their first healthcare provider for occupational back pain. The purpose of this study is to identify characteristics associated with the choice of first healthcare provider seen for acute uncomplicated occupational back pain.MethodsWe analyzed data collected by the Workplace Safety and Insurance Board from a cohort of workers with compensated back pain in 2005 in Ontario (Canada). Multivariable logistic regression models were created to identify factors associated with the type of first healthcare provider seen (chiropractor, physician, or physiotherapist). Adjustments to the final models were evaluated using the area under the receiver-operating characteristics curve (ROC).ResultsAccording to the 5520 analyzed claims, 85.3 % of the patients saw a physician, 11.4 % saw a chiropractor, and 3.2 % saw a physiotherapist. Longer job tenure (odds ratio (OR) = 1.02, P = 0.004), higher gross personal income (OR = 1.06, P = 0.018), mixed-manual job (OR = 1.35, P = 0.004) and previous similar injury (OR = 1.60, P < 0.001) increased the odds of seeing a chiropractor rather than a physician, while the size of the community (>500,000 inhabitants) and the availability of an early return to work program in the workplace (OR = 0.77, P = 0.035) decreased it. The odds of seeing a physiotherapist rather than a physician increased with increasing age (OR = 1.19, P = 0.019), previous similar injury (OR = 1.71, P < 0.001) and severity of injury (OR = 2.03, P = 0.010). Increased age (OR = 1.28, P = 0.008) and size of community (>1,500,000 inhabitants; OR = 2.58, P = 0.002) increased the odds of seeing a physiotherapist rather than a chiropractor, while holding a mixed-manual job significantly decreased those odds (OR = 0.63, P = 0.044). The area under the ROC curve of our multivariable models varied from 0.62 to 0.64.ConclusionThe type of first healthcare provider sought for occupational back pain is influenced by injury-and work-related factors and by the worker’s age, income and community size. Contrary to previous studies, the workers who first sought a physician did not have higher odds of having a severe injury.

【 授权许可】

CC BY   
© The Author(s). 2016