title: A population-based analysis of healthcare utilization of persons with back disorders: results from the Canadian Community Health Survey 2000-2001.
abstract: METHODS
  A retrospective, population-based analysis.
  
  
  OBJECTIVE
  To analyze the utilization of a variety of healthcare services for persons with and without a chronic back disorder, and to identify factors associated with specific patterns of healthcare resource use.
  
  
  BACKGROUND
  Although there have been studies of how chronic back disorders influence the use of specific healthcare services, we do not currently have a broad, population-based overview of how this condition influences healthcare service utilization.
  
  
  METHODS
  Person-level data were taken from the 2000-2001 Canadian Community Health Survey (CCHS), a nationwide cross-sectional survey of health determinants, health status, and health system utilization of Canadians. A series of binary logistic regressions examining healthcare resource utilization were performed on a full study sample (n = 113,229), as well as a restricted sample (n = 36,713) with attention focused on subjects with a single diagnosis of a chronic back disorder.
  
  
  RESULTS
  Persons with chronic back disorders were more likely to use physician resources (multivariate odds ratio [OR] = 1.2; 95% confidence interval, 1.1-1.2), and nonphysician resources (OR range, 2.1-3.6) compared with persons without the condition, with chiropractic care having an odds ratio of 3.6 (95% confidence interval, 3.5-3.8). Higher socioeconomic status, the presence of activity-limiting pain, and depressive symptoms were associated with a significant increase in utilization of almost all healthcare services.
  
  
  CONCLUSIONS
  With increasing disability as indicated by the presence of pain and functional limitations, and the presence of depressive symptoms, the higher the utilization of physician and nonphysician resources, with the exception of chiropractic care, which appears to be used by those with less severe symptoms. Lower socioeconomic status was associated with significantly lower receipt of services for almost all healthcare providers.
authors.affiliation: Department of Economics and University Scholars Programme, National University of Singapore, Singapore.
authors.forename: Kim-Lian
authors.initials: KL
authors.lastname: Lim
authors.forename: Philip
authors.initials: P
authors.lastname: Jacobs
authors.forename: Scott
authors.initials: S
authors.lastname: Klarenbach
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000453:epidemiology* / Q000628:therapy; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care