Early patterns of care for occupational back pain.
METHODS
Cross-sectional analysis.


OBJECTIVE
To describe the early health care utilization for occupational back pain. To identify factors associated with health care seeking and provider choice among persons with occupational back pain.


BACKGROUND
Back pain is the most prevalent work-related injury, yet little is known about patterns of care for occupational back pain.


METHODS
The sample includes 1104 workers with incident episodes of low back pain. Outcomes measures include whether or not workers received care and the types of providers seen. Predictors of outcomes include demographics, injury severity, history of back pain, occupation, and employer.


RESULTS
Eight percent of workers did not receive care in the first 4 to 16 weeks after filing a workers' compensation claim. Injury severity, gender, occupation, and employer were significant predictors of the decision to seek care. Almost 90% of workers who received care were treated by medical physicians, often in combination with physical therapists or chiropractors. Age, occupation, injury severity, and whether the employer or worker chose the initial health care provider were associated with the choice of provider. Employers selected providers for 78% of injured workers who received care. Medical physicians were the providers most often chosen by both employers and workers, but workers were more likely than employers to select chiropractors.


CONCLUSIONS
A small but significant number of injured workers do not seek care for their back pain. Medical physicians treat all but a small fraction of the workers who receive care. The decision to seek care and the choice of providers is associated with injury severity, occupation, and employer actions.
Côté
Pierre
P
Institute for Work & Health and Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada. pcote@iwh.on.ca
Baldwin
Marjorie L
ML
Johnson
William G
WG
D000328:Adult; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000628:therapy*; D016017:Odds Ratio; D011446:Prospective Studies; D013997:Time Factors