Behavioral and Access Barriers to Seeking Chiropractic Care: A Study of 3 New York Clinics

Stevens, Gerald L.

doi:10.1016/j.jmpt.2007.07.015

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…Incorporating first-line therapies as an alternative to low value second- and third-line therapies may help address PCP concerns about the cost of non-pharmacological therapies. Additional potential barriers to accessing non-pharmacologic health care services that may impact PCP referral include limited or lack of benefit coverage, wait times for treatment, transportation barriers, the need to secure time away from work to participate in multiple visits, and individual characteristics 20,46 .…”

Section: Discussionmentioning

confidence: 99%

Low back pain service utilization and costs: association with timing of first-line services for individuals initially contacting a primary care provider. A retrospective cohort study

Elton

Zhang

2022

Preprint

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Background: Low back pain (LBP) is prevalent, costly, and a common reason for a visit to a primary care provider (PCP). Guidelines recommend a stepped approach to management. Objective: For individuals with LBP initially contacting a PCP, examine the association between the incorporation of first-line therapies, use of second- and third-line services and total episode cost. Design: Retrospective cohort study Setting/Patients: National sample of individuals with non-surgical LBP occurring in 2017-2019. Measurements: Independent variables were initial contact with a PCP, and the timing of incorporation of 5 types of first-line therapies. Dependent measures included use of 14 types of health care services and total episode cost. Results: 8.5% of 118,503 PCPs initially contacted by 308,790 individuals with 347,627 episodes of non-surgical LBP were associated with an episode including any first-line service at any time. 17.5% of episodes included any first-line service at any time. Active care (11.6% of episodes), manual therapy (8.0%) and chiropractic manipulative therapy (7.0%) were the most common first line services. 5.4% of episodes included a first-line service during the first 7 days. These episodes were associated with a modest reduction in the use of prescription pharmaceuticals, with no impact on the use of imaging or spinal injection. First-line services were associated with an increase in total episode cost with the smallest increase associated with chiropractic and osteopathic manipulation. Younger individuals from ZIP codes with higher adjusted gross income were more likely to receive a first-line service in the first 7 days of an episode. Limitations: As a retrospective observational analysis of associations there are numerous potential confounders and limitations. Conclusions: Individuals with non-surgical LBP initially contacting a PCP infrequently receive a first-line service, and if received, it is typically in addition to second- and third-line pharmaceutical, imaging, and interventional services. There is an opportunity to improve concordance with the stepped approach to management described in LBP guidelines.

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Section: Discussionmentioning

confidence: 99%

Low back pain service utilization and costs: association with timing of first-line services for individuals initially contacting a primary care provider. A retrospective cohort study

Elton

Zhang

2022

Preprint

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“…Previous research reported that access barriers of transportation, cost, and insurance benefits were not present for students seeking chiropractic care at a free university health center. 1 In the current study, removing geographic constraints and economic considerations may have improved interprofessional communications and discussions and provided an opportunity to reduce bias and enhance knowledge and understanding of chiropractic care, thereby facil-itating interprofessional referrals. 41 Removing geographic constraints also aligns with referral patterns of medical doctors to doctors of chiropractic, in which medical patients are expected to contact the doctor of chiropractic on their own.…”

Section: Discussionmentioning

confidence: 91%

“…Cost, lack of insurance, type of insurance, and transportation are types of access barriers for patients seeking chiropractic care. 1 Many studies on demographics and clinical characteristics of chiropractic patients exist in the literature. Research indicates that chiropractic patients in the United States are between 38 and 45 years of age, approximately 60% female, and mostly white and well educated, and between 41% and 68% have low back pain as a chief complaint.…”

Section: Introductionmentioning

confidence: 99%

“…Preliminary survey data indicated that acute or subacute low back pain was the primary complaint of young adults 18 to 29 years of age seeking care at a free chiropractic clinic within a university health center. 1 A free student health center provides an opportunity to focus on demographics and patient characteristics of young adults 18 to 29 years of age seeking chiropractic care. Although the free student health center is limited to enrolled university students, this sample of students addresses access barriers of cost and transportation for young adults seeking chiropractic care.…”

Section: Introductionmentioning

confidence: 99%

“…Although the free student health center is limited to enrolled university students, this sample of students addresses access barriers of cost and transportation for young adults seeking chiropractic care. 1 This student sample also avoids the bias of young adults being chiropractic students who receive multiple spinal manipulations during their educational training and have no behavioral barriers toward chiropractic care. Contributing information to literature on clinical characteristics of chiropractic patients 18 to 29 years of age will add to our understanding of chiropractic care across the lifespan.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Retrospective Demographic Analysis of Patients Seeking Care at a Free University Chiropractic Clinic

Stevens

Campeanu

Sorrento

et al. 2016

Journal of Chiropractic Medicine

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Equity, diversity, and inclusion in chiropractic: Aligning the profession to serve tomorrow’s diverse world

Johnson,

Green,

Ahmed

et al. 2025

Equity, Diversity, and Inclusion in Healthcare

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Behavioral and Access Barriers to Seeking Chiropractic Care: A Study of 3 New York Clinics

Cited by 9 publications

References 7 publications

Low back pain service utilization and costs: association with timing of first-line services for individuals initially contacting a primary care provider. A retrospective cohort study

Low back pain service utilization and costs: association with timing of first-line services for individuals initially contacting a primary care provider. A retrospective cohort study

Retrospective Demographic Analysis of Patients Seeking Care at a Free University Chiropractic Clinic

Equity, diversity, and inclusion in chiropractic: Aligning the profession to serve tomorrow’s diverse world

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