Kirby Emma R, Broom Alex F, Sibbritt David W, Refshauge Kathryn M, Adams Jon
School of Social Science, University of Queensland, Brisbane, Queensland, Australia.
Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
PLoS One. 2013 Dec 20;8(12):e83559. doi: 10.1371/journal.pone.0083559. eCollection 2013.
Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date.
To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage.
Survey of 1,310 women (response rate 80.9%) who reported seeking help for back pain from the '1946-51 cohort' of the Australian Longitudinal Study on Women's Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage.
In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0) different health care practitioners, and had, on average, 12.2 (SD = 9.7) discrete health care practitioner consultations for back pain. Average self-reported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10.
Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress) points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women's access to multiple providers. We extrapolate that for Australian working-age women, total out-of-pocket expenditure on back pain care per annum is in excess of AU$1.4 billion, thus indicating the prominence of back pain as a major economic, social and health burden.
背痛在澳大利亚人群的一生中影响着很大一部分人，在女性中患病率很高，尤其是在老年女性中。背痛护理的特点是有多种从业者和自我开方的治疗选择，而与咨询和自我开方治疗相关的自付费用迄今尚未得到研究。
分析澳大利亚女性因背痛护理而咨询医疗保健从业者和自我开方治疗的程度，并评估与这种使用相关的自我报告费用。
对1310名女性进行调查（回复率80.9%），这些女性报告在澳大利亚女性健康纵向研究的“1946 - 51队列”中因背痛寻求帮助。询问女性关于她们因背痛使用医疗保健从业者和自我开方治疗的情况以及与此类使用相关的费用。
在过去一年中，76.4%的女性咨询了补充和替代医学从业者，56%咨询了专职医疗从业者，59.2%咨询了全科医生/医学专家。总体而言，女性平均咨询3.0（标准差 = 2.0）名不同的医疗保健从业者，因背痛平均进行12.2（标准差 = 9.7）次不同的医疗保健从业者咨询。每年因背痛护理在从业者和自我开方治疗方面的平均自我报告自付支出为873.10澳元。
为了不同但明确的目的（即疼痛/活动能力与焦虑/压力）而使用多种医疗服务提供者，这表明需要进一步研究患者在背痛护理方面的动机和经历，以改善和加强获得护理的机会以及护理的连续性。我们的结果表明，背痛护理的成本是一项重大负担，最终可能会限制女性获得多种医疗服务提供者的机会。我们推断，对于澳大利亚工作年龄的女性来说，每年因背痛护理的自付总支出超过14亿澳元，这表明背痛作为主要的经济、社会和健康负担的突出性。
