加拿大慢性背痛患者使用不同医疗服务提供者的医疗保健利用率及其特征：一项基于人群的研究。
Prevalence and characteristics of healthcare utilization with different providers among Canadians with chronic back problems: A population-based study.
作者信息
Wong Jessica J, Wang Dan, Hogg-Johnson Sheilah, Mior Silvano A, Côté Pierre
机构信息
Institute for Disability and Rehabilitation Research, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada.
Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, L1G 0C5, Canada.
出版信息
Brain Spine. 2024 Apr 16;4:102812. doi: 10.1016/j.bas.2024.102812. eCollection 2024.
INTRODUCTION
Understanding healthcare utilization by Canadians with back problems informs healthcare planning nationally.
RESEARCH QUESTION
What is the prevalence of utilization of healthcare providers (medical doctors, chiropractors, physiotherapists, nurses), and associated characteristics among Canadians with chronic back problems (2001-2016)?
MATERIAL AND METHODS
This population-based study used Canadian Community Health Survey data (2001-2016) restricted to respondents with chronic back problems (aged ≥12 years). We used self-reported consultation with healthcare providers (medical doctors, chiropractors, physiotherapists, nurses) from 2001-2010, and self-reported regular healthcare provider from 2015-2016. We calculated the 12-month prevalence of utilization with providers, and used modified Poisson regression to assess sociodemographic, health-related and behavioural factors associated with utilization of different providers.
RESULTS
From 2001 to 2010 and 2015/2016, respectively, prevalence of utilization of medical doctors was 87.9% (95% CI 87.6-88.2) and 86.7% (95% CI 85.9-87.5); chiropractors 24.0% (95% CI 23.6-24.4) and 14.5% (95% CI 13.8-15.3); physiotherapists 17.2% (95% CI 16.9-17.6) and 10.7% (95% CI 10.0-11.4); nurses 14.0% (95% CI 13.7-14.2) and 6.6% (95% CI 6.1-7.0). Females were more likely to see any provider than males. Persons of lower socioeconomic status were less likely to consult chiropractors or physiotherapists (2001-2016), or nurses (2001-2010). Immigrants were less likely to consult chiropractors or nurses. Persons aged >65 years were less likely to consult chiropractors or physiotherapists, and those with fair/poor general health were less likely to consult chiropractors, but more likely to consult other providers.
DISCUSSION AND CONCLUSION
Medical doctors were most commonly consulted by Canadians with back problems, then chiropractors and physiotherapists. Characteristics of healthcare utilization varied by provider. Findings inform the need to strengthen healthcare delivery for Canadians with back problems.
引言
了解患有背部问题的加拿大人的医疗保健利用情况有助于全国的医疗保健规划。
研究问题
在患有慢性背部问题的加拿大人中（2001 - 2016年），医疗保健提供者（医生、脊椎按摩师、物理治疗师、护士）的利用率及其相关特征是什么？
材料与方法
这项基于人群的研究使用了加拿大社区健康调查数据（2001 - 2016年），数据仅限于患有慢性背部问题的受访者（年龄≥12岁）。我们使用了2001 - 2010年期间自我报告的与医疗保健提供者（医生、脊椎按摩师、物理治疗师、护士）的咨询情况，以及2015 - 2016年期间自我报告的常规医疗保健提供者情况。我们计算了与提供者的12个月利用率，并使用修正泊松回归来评估与不同提供者利用情况相关的社会人口统计学因素、健康相关因素和行为因素。
结果
分别在2001年至2010年以及2015/2016年，医生的利用率分别为87.9%（95%置信区间87.6 - 88.2）和86.7%（95%置信区间85.9 - 87.5）；脊椎按摩师为24.0%（95%置信区间23.6 - 24.4）和14.5%（95%置信区间13.8 - 15.3）；物理治疗师为17.2%（95%置信区间16.9 - 17.6）和10.7%（95%置信区间10.0 - 11.4）；护士为14.0%（95%置信区间13.7 - 14.2）和6.6%（95%置信区间6.1 - 7.0）。女性比男性更有可能咨询任何提供者。社会经济地位较低的人咨询脊椎按摩师或物理治疗师（2001 - 2016年）或护士（2001 - 2010年）的可能性较小。移民咨询脊椎按摩师或护士的可能性较小。65岁以上的人咨询脊椎按摩师或物理治疗师的可能性较小，而总体健康状况为一般/较差的人咨询脊椎按摩师的可能性较小，但咨询其他提供者的可能性较大。
讨论与结论
患有背部问题的加拿大人最常咨询的是医生，其次是脊椎按摩师和物理治疗师。医疗保健利用的特征因提供者而异。研究结果表明有必要加强为患有背部问题的加拿大人提供医疗服务。
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