Prevalence and characteristics of healthcare utilization with different providers among Canadians with chronic back problems: A population-based study

doi:10.1016/j.bas.2024.102812

. 2024 Apr 16:4:102812.

doi: 10.1016/j.bas.2024.102812. eCollection 2024.

Prevalence and characteristics of healthcare utilization with different providers among Canadians with chronic back problems: A population-based study

Jessica J Wong^{1

2

3

4}, Dan Wang^{1

2

5}, Sheilah Hogg-Johnson^{1

5

6}, Silvano A Mior^{1

2

5

4}, Pierre Côté^{1

2

4

6}

Affiliations

¹ Institute for Disability and Rehabilitation Research, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada.
² Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, L1G 0C5, Canada.
³ Graduate Studies, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario, M5T 3M6, Canada.
⁵ Department of Research and Innovation, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
⁶ Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada.

PMID: 38698804
PMCID: PMC11063586
DOI: 10.1016/j.bas.2024.102812

Prevalence and characteristics of healthcare utilization with different providers among Canadians with chronic back problems: A population-based study

Jessica J Wong et al. Brain Spine. 2024.

. 2024 Apr 16:4:102812.

doi: 10.1016/j.bas.2024.102812. eCollection 2024.

Authors

Jessica J Wong^{1

2

3

4}, Dan Wang^{1

2

5}, Sheilah Hogg-Johnson^{1

5

6}, Silvano A Mior^{1

2

5

4}, Pierre Côté^{1

2

4

6}

Affiliations

¹ Institute for Disability and Rehabilitation Research, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada.
² Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, L1G 0C5, Canada.
³ Graduate Studies, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario, M5T 3M6, Canada.
⁵ Department of Research and Innovation, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
⁶ Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada.

PMID: 38698804
PMCID: PMC11063586
DOI: 10.1016/j.bas.2024.102812

Abstract

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.

Keywords: Back pain; Canadian Community Health Survey; Health care providers; Population-based; Prevalence.

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Conflict of interest statement

Jessica Wong is supported by a Canadian Institutes of Health Research (CIHR) Research Excellence, Diversity and Independence Early Career Transition Award, was previously supported by a Banting Postdoctoral Fellowship from CIHR and reports research grant from the Canadian Chiropractic Research Foundation (paid to university); research grants from CIHR, Social Sciences and Humanities Research Council (SSHRC), Canadian Memorial Chiropractic College and Canadian Chiropractic Research Foundation (paid to university) and travel reimbursement for teaching and research meetings from Eurospine and Chiropractic Academy of Research Leadership outside the submitted work. Dan Wang reports research grant from the Canadian Chiropractic Research Foundation (paid to Ontario Tech University) and postdoctoral fellowship at Ontario Tech University (funded by Ontario Tech University and Canadian Memorial Chiropractic College). Sheilah Hogg-Johnson reports research grant from the Canadian Chiropractic Research Foundation (paid to Ontario Tech University); and research grants from the Canadian Chiropractic Research Foundation outside the submitted work. Silvano Mior reports research grant from the Canadian Chiropractic Research Foundation (paid to Ontario Tech University); research grants from the Canadian Chiropractic Research Foundation (paid to Ontario Tech University and Canadian Memorial Chiropractic College) and Canadian Chiropractic Association (paid to Canadian Memorial Chiropractic College), and honoraria for lecturing from the Chiropractic Association of Saskatchewan outside the submitted work. Pierre Côté was supported by the Canada Research Chair award from CIHR (paid to Ontario Tech University), and reports research grant from the Canadian Chiropractic Research Foundation (paid to Ontario Tech University); research grants from CIHR, Canadian Chiropractic Research Foundation, and College of Chiropractors of British Columbia (paid to Ontario Tech University), payment to provide medical-legal expertise in court cases from the Canadian Chiropractic Protective Association and NCMIC, and travel reimbursement to the university for teaching and conference presentations from Eurospine, European Chiropractic Union and Chiropractic Association of Alberta outside the submitted work.

Cited by

Assessing the change in prevalence and characteristics of canadians utilizing chiropractic services across two time periods 2001-2010 and 2015-2018: a population-based repeated cross-sectional study.
Mior S, Wang D, Wong JJ, Hogg-Johnson S, Côté P. Mior S, et al. Chiropr Man Therap. 2024 Oct 30;32(1):30. doi: 10.1186/s12998-024-00552-1. Chiropr Man Therap. 2024. PMID: 39478579 Free PMC article.

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[1] Abdi S., Spann A., Borilovic J., de Witte L., Hawley M. Understanding the care and support needs of older people: a scoping review and categorisation using the WHO international classification of functioning, disability and health framework (ICF) BMC Geriatr. 2019;19(1):195. - PMC - PubMed

[2] Abdi S., Spann A., Borilovic J., de Witte L., Hawley M. Understanding the care and support needs of older people: a scoping review and categorisation using the WHO international classification of functioning, disability and health framework (ICF) BMC Geriatr. 2019;19(1):195. - PMC - PubMed

[3] Ahmadzadeh Amiri A., Genevay S., Ahmadzadeh Amiri A., Daneshvar F., Yazdani Charati J., Ghafouri M., et al. Adding a back care package to the primary healthcare; a community-based cluster-randomized trial. Brain Spine. 2023;3 - PMC - PubMed

[4] Ahmadzadeh Amiri A., Genevay S., Ahmadzadeh Amiri A., Daneshvar F., Yazdani Charati J., Ghafouri M., et al. Adding a back care package to the primary healthcare; a community-based cluster-randomized trial. Brain Spine. 2023;3 - PMC - PubMed

[5] Bath B., Lawson J., Ma D., Trask C. Self-reported use of family physician, chiropractor and physiotherapy services among adult Canadians with chronic back disorders: an observational study. BMC Health Serv. Res. 2018;18(1):970. - PMC - PubMed

[6] Bath B., Lawson J., Ma D., Trask C. Self-reported use of family physician, chiropractor and physiotherapy services among adult Canadians with chronic back disorders: an observational study. BMC Health Serv. Res. 2018;18(1):970. - PMC - PubMed

[7] Canadian Institute for Health Information (CIHI) Geographic istribution of physicians in Canada: beyond how many and where. 2015. https://secure.cihi.ca/free_products/Geographic_Distribution_of_Physicia... Available at:

[8] Canadian Institute for Health Information (CIHI) Geographic istribution of physicians in Canada: beyond how many and where. 2015. https://secure.cihi.ca/free_products/Geographic_Distribution_of_Physicia... Available at:

[9] Canadian Medical Association Statement: governments must collaborate now to fix Canada's collapsing health care system. CMA. 2022 https://www.cma.ca/news-releases-and-statements/statement-governments-mu... Available at:

[10] Canadian Medical Association Statement: governments must collaborate now to fix Canada's collapsing health care system. CMA. 2022 https://www.cma.ca/news-releases-and-statements/statement-governments-mu... Available at:

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Prevalence and characteristics of healthcare utilization with different providers among Canadians with chronic back problems: A population-based study

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Prevalence and characteristics of healthcare utilization with different providers among Canadians with chronic back problems: A population-based study

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