The effects of comorbidity and other factors on medical versus chiropractic care for back problems.
METHODS
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.


OBJECTIVE
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.


BACKGROUND
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.
Hurwitz
E L
EL
Department of Epidemiology, School of Public Health, University of California-Los Angeles 90095-1772, USA.
Morgenstern
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D000293:Adolescent; D000328:Adult; D000368:Aged; D002684:Chiropractic / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*