CARE SEEKING AND CONSULTATION WITH SPINE SPECIALISTS

急性腰背痛是一种常见症状。与低成本相关的成本 据估计，背部疼痛的护理费用高达250亿美元。 年。大多数急性下腰痛的患者都会从 脊椎按摩师或初级保健医生。而整体的预后 急性背痛的情况是好的，我们发现30%的患者寻求 来自第二个医疗保健提供者的护理。骨科和神经科 外科医生在脊柱疾病方面有特殊的专业知识。我们建议 对我们小组以前在自然历史方面所做的工作进行了扩展 以及急性腰背痛的病程利用现有的人群- 基于对1,633名患者的调查和前瞻性队列。我们会 回答两个问题： 1(A)。从脊柱寻求护理的相关性是什么？ 专家--骨科还是神经外科医生？ 1(B)。从脊椎寻求护理与哪些因素相关 在最初寻求治疗的患者中担任专家 是其他专业的从业者吗？ 2.病人满意度与 咨询脊椎专家？ 我们预计症状的持续时间将是一个主要的决定因素 咨询脊椎专家。的前瞻性质 这些数据将使我们能够量化这种关系。我们还将 检查可能与使用 脊柱专家：人口统计因素；最初的专业 提供者看到(初级保健与脊椎按摩师与医疗保健组织)；工人的 薪酬状况；保险状况；对 索引提供程序和其他。我们还将检查患有长期- 持续背部疼痛(超过3个月)，没有寻求治疗 脊椎专家。这样的病人是这种会诊的候选对象。 在许多指导方针中。因此，这项研究可以检查相关的因素 咨询或转介，以及当前 关于脊柱可能过度和不足的指导方针 专家。

Acute low back pain is a common symptom. Costs associated with low back pain care are estimated to be as high as 25 billion dollars per year. Most patients with acute low back pain seek care from a chiropractor or a primary care physician. While the overall prognosis of acute back pain is good, we have found that 30% of patients seek care from a second health care provider. Orthopedic and neurologic surgeons have special expertise in spine disease. We propose to expand on previous work performed by our group on the natural history and course of acute low back pain utilizing a pre-existing population- based survey and prospective cohort of 1,633 patients. We will address two questions: 1 (a). What are the correlates of care seeking from a spine specialist-orthopedic or neurologic surgeon? 1 (b). What factors are associated with care seeking from a spine specialist among patients who had initially sought care from a practitioner in another specialty? 2. What is the relationship between patient satisfaction and consultation with a spine specialist? We anticipate that duration of symptoms will be a major determinant of consultation with a spine specialist. The prospective nature of the data will allow us to quantify this relationship. We will also examine a number of variables which may be associated with use of a spine specialist: demographic factors; specialty of the initial provider seen (primary care vs. chiropractor vs. HMO); workers' compensation status; insurance status; poor satisfaction with the index provider and others. We shall also examine patients with long- duration back pain (more than 3 months) who did not seek care from a spine specialist. Such patients are candidates for such consultation in many guidelines. The study thus can examine the factors associated with consultation or referral, and the consequences of current guidelines on possible over and under-utilization of spine specialists.