Shekelle P G, Markovich M, Louie R
West Los Angeles VAMC, California, USA.
Spine (Phila Pa 1976). 1995 Aug 1;20(15):1668-73. doi: 10.1097/00007632-199508000-00004.
This was a prospective community-based, observational design.
To describe the epidemiology and risk/prognostic factors for back pain episodes of care in a population representing the nonelderly in the United States.
Previous United States studies of the epidemiology of back pain care have used defined industrial populations or have relied on the patient's recall of symptoms and care.
Claims forms from the RAND Health Insurance Experiment, a randomized controlled trial of the use of health services, were analyzed. Claims forms were selected if one of the patient-designated reasons for the visit was back pain. Visits were grouped into episodes of care. Descriptive statistics were calculated for episodes. Multivariate logistic regression was used to calculate adjusted odds ratios for independent explanatory sociodemographic and health status variables associated with back pain episodes of care.
The 3105 adults in the Health Insurance Experiment had a combined 11,171 person-years of exposure. Six-hundred-eighty-six persons (22%) had a total 1020 episodes of back pain care, representing 8825 visits. Seventy-one percent of persons had a single episode during the Health Insurance Experiment, and 40% of these episodes consisted of a single visit. There were 9.1 episodes per 100 person-years. Insurance status, geographic site, white race, lesser education, poorer physical functioning, and greater pain at base-line all were independently associated with having a back pain episode of care.
Back pain episodes of care occur commonly in the adult U.S. population, but usually are brief and recur infrequently.
这是一项基于社区的前瞻性观察性设计。
描述美国非老年人群中背痛护理事件的流行病学以及风险/预后因素。
美国以往关于背痛护理流行病学的研究使用的是特定行业人群，或者依赖患者对症状和护理的回忆。
对兰德健康保险实验（一项关于医疗服务使用的随机对照试验）的理赔申请表进行分析。若患者指定的就诊原因之一是背痛，则选取该理赔申请表。就诊被分组为护理事件。计算护理事件的描述性统计数据。使用多变量逻辑回归计算与背痛护理事件相关的独立解释性社会人口统计学和健康状况变量的调整比值比。
健康保险实验中的3105名成年人共有11171人年的暴露时间。686人（22%）共发生1020次背痛护理事件，代表8825次就诊。71%的人在健康保险实验期间有单次护理事件，其中40%的护理事件仅包含一次就诊。每100人年有9.1次护理事件。保险状况、地理位置、白人种族、受教育程度较低、身体功能较差以及基线时疼痛程度较高均与背痛护理事件独立相关。
背痛护理事件在美国成年人群中普遍发生，但通常较为短暂且很少复发。
