THE EFFECTS OF COMORBIDITY AND OTHER FACTORS ON MEDICAL VERSUS CHIROPRACTIC CARE FOR BACK PROBLEMS

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.