The effect of comorbidity on care seeking for back problems in the United States

PURPOSE: We assess the effect of comorbidity on self-reported use of health care for back problems in the United States. METHODS: Data from the 1989 National Health Interview Survey (NHIS) were us ed to perform cross-sectional analyses of adults who reported a back-relate d condition. The presence of one or more nonback-related conditions (and as sociated disability and health care) were the primary predictor variables. Weighted logistic regression modeling was performed to estimate odds ratios (ORs) adjusted for the effects of covariates RESULTS: The 1989 NHIS included 84,572 adults, of which 4790 (5.7%) reporte d at. least one back-related condition. Of these, 931 (19.6%) sought health care for their back condition during the 2-week reference period. Among al l adults with reported back problems, those with disabling comorbidities an d those who sought care for their comorbidities during the reference period were less likely to have sought back care than were those with no comorbid ities. Subjects with back-related disabilities who reported nandisabling co morbidities without associated health care were much more likely to have so ught back care than were similar subjects without any comorbidities. CONCLUSIONS: The decision to seek care for a back problem is a complex proc ess that depends upon the presence and impact of other conditions and the u se of care for these conditions. Comorbid back problem sufferers may not se ek back care when afflicted with other disabling conditions or conditions t hat may be perceived to be more amenable to care. (C) 1999 Elsevier Science Inc. All rights reserved.