Using a behavioral model to identify factors associated with choice of provider for neck and low back pain: A systematic review.

BACKGROUND: It remains unclear as to what factors influence a patient's choice to seek care from a specific healthcare provider for low back and neck pain. OBJECTIVE: Utilize Andersen's Behavioral Model of Health Service Utilization as a conceptual framework to identify the predisposing, enabling and need factors associated with choice of healthcare provider for back and/or neck pain. METHODS: PubMed, CINAHL, EMBASE, and SCOPUS databases were searched for studies that included 1) patients seeking care for acute or chronic low back or neck pain; 2) patients at least 18 years of age; 3) reported any healthcare provider type chosen to be seen. Significant factors addressing a patient's choice of provider seen for back pain, neck pain, or both were extracted from studies and analyzed under the Behavioral Model of Health Service Utilization. RESULTS: 20 studies were included in this review: 17 quantitative studies and 3 qualitative studies. Provider types identified were medical physicians, chiropractors, physical therapists, acupuncturists and CAM providers. Age and sex were the most commonly reported predisposing factors; financial and personal factors were the most common enabling factors; patients' duration of pain and self-reported level of functioning were the most commonly reported need factors. CONCLUSIONS: While predisposing and need factors are important, enabling factors also have an influence in choice of healthcare provider for back and/or neck pain.

Duke Scholars

Author Derek James Clewley Orthopaedic Surgery, Physical Therapy

Author Maggie Elizabeth Horn Orthopaedic Surgery, Physical Therapy