Department of Physical Therapy, Springfield College, Springfield, MA 01109, USA.
J Orthop Sports Phys Ther. 2011 Jul;41(7):467-76. doi: 10.2519/jospt.2011.3637. Epub 2011 Jun 7.
Secondary analysis of longitudinal population-based survey data.
To investigate factors associated with care seeking for physician-referred physical therapy (MD/PT), as compared to physician-only (MD) or chiropractic-only (DC) care for spinal pain.
Although a large proportion of ambulatory physical therapy visits are related to spinal pain, physical therapists are not the most commonly seen provider. The majority of visits are to physicians, followed by chiropractors. We attempted to understand more about this disparity by examining social and demographic factors that differentiate between persons who see these providers.
Episodes of care were constructed from participants in 2 panels from the Medical Expenditure Panel Survey who had spinal pain. The provider of care was identified for each episode, and logistic regression was used to determine factors associated with MD/PT use compared to MD use, and MD/PT use compared to DC use.
The majority of patients (61%) received MD care for spinal pain, followed by those who received DC (28%) and MD/PT (11%) care. Female sex, higher levels of education, and higher income were significantly associated with MD/PT care over MD care. Increased age, female sex, lower self-health rating, and presence of at least 1 disability day were all significantly associated with MD/PT care over DC care.
Sociodemographic and clinical factors are associated with those who get MD/PT care as compared to MD or DC care. We found evidence of an access disparity for physical therapy and identified population characteristics that both increase and reduce the likelihood of physical therapy service use.
基于人群的纵向调查数据的二次分析。
研究与医生转诊的物理治疗（MD/PT）相比，与医生（MD）或脊椎按摩（DC）治疗相比，与寻求治疗相关的因素，用于治疗脊椎疼痛。
尽管很大一部分门诊物理治疗就诊与脊椎疼痛有关，但物理治疗师并不是最常见的治疗师。大多数就诊是去看医生，其次是脊椎按摩师。我们试图通过检查社会和人口统计学因素来了解更多有关这种差异的信息，这些因素可以区分接受这些提供者治疗的患者。
从医疗支出调查（MEPS）的两个小组中患有脊椎疼痛的参与者中构建治疗期。为每个治疗期确定了治疗提供者，并使用逻辑回归确定了与 MD/PT 相比 MD 治疗以及与 MD/PT 相比 DC 治疗相关的因素。
大多数患者（61％）因脊椎疼痛接受 MD 治疗，其次是接受 DC（28％）和 MD/PT（11％）治疗的患者。女性，较高的教育水平和较高的收入与 MD/PT 治疗相比 MD 治疗显著相关。年龄增加，女性，自我健康评分较低以及至少有 1 个残疾日与 MD/PT 治疗相比 DC 治疗显著相关。
社会人口统计学和临床因素与接受 MD/PT 治疗相比 MD 或 DC 治疗的患者有关。我们发现物理治疗存在获得服务的差异，并确定了既增加又减少物理治疗服务使用可能性的人群特征。
