El. Hurwitz et H. Morgenstern, THE EFFECTS OF COMORBIDITY AND OTHER FACTORS ON MEDICAL VERSUS CHIROPRACTIC CARE FOR BACK PROBLEMS, Spine (Philadelphia, Pa. 1976), 22(19), 1997, pp. 2254-2263
Study Design. This study is a cross-sectional analysis of adults in th
e United States who reported at least one back-related visit to a heal
th care professional during a 2-week reference period. Objectives. To
estimate and compare the effects of comorbidity and other factors on s
elf-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 an the predictors of chiroprac
tic and medical care among back pain patients. Methods. Data from the
1989 National Health Interview Survey were used to perform a cross-sec
tional 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 varia
bles. Weighted logistic regression modeling was performed to estimate
odds ratios adjusted for the effects of covariates. Results. Of the 47
90 adults with reported back problems, 931 sought health care for thei
r back condition during the 2-week reference period. Adults with disab
ling comorbidities and back-related restricted-activity days were rela
tively 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 relat
ively more likely to use chiropractic care than primary medical care.
Conclusions. The presence of comorbidity-related or back-related disab
ility, as well as other factors, affect the type of care sought for ba
ck conditions among adults in the United States.