Patient attitudes, insurance, and other determinants of self-referral to medical and chiropractic physicians.
OBJECTIVE
This study identified predictors of patient choice of a primary care medical doctor or chiropractor for treatment of low back pain.


METHODS
Data from initial visits were derived from a prospective, longitudinal, nonrandomized, practice-based observational study of patients who self-referred to medical and chiropractic physicians (n = 1414).


RESULTS
Logistic regression showed differences between patients who sought care from medical doctors vs chiropractors in terms of patient health status, sociodemographic characteristics, insurance, and attitudes. Disability, insurance, and trust in provider types were particularly important predictors.


CONCLUSIONS
The study highlights the importance of patient attitudes, health status, and insurance in self-referral decisions. The significance of patient attitudes suggests that education might be used to shape attitudes and encourage cost-effective care choices.
Sharma
Rajiv
R
Department of Economics, Portland State University, Portland, OR 97230, USA.
Haas
Mitchell
M
Stano
Miron
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002684:Chiropractic / Q000191:economics / Q000706:statistics & numerical data*; D002755:Choice Behavior; D003710:Demography; D005194:Family Practice / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007357:Insurance, Physician Services; D016015:Logistic Models; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009922:Oregon; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011594:Psychometrics; D012959:Socioeconomic Factors; D014861:Washington