2. Orthopedic Resident, Thomas Jefferson University Orthopedic Physical Therapy Residency Program Christiana Care Health Services, 3506 Kennett Pike Wilmington, Delaware, USA.
3. PT Educator, University of Delaware Physical Therapy Department Clinic 540 South College Ave, Suite 160, ewark, Delaware, USA.
4. Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics Jefferson (Philadelphia University + Thomas Jefferson University) Jefferson - Center City Campus, 1015 Chestnut Street, Suite 520, Philadelphia, USA.
Background/Purpose: The prevalence of low back pain (LBP) continues to rise and an appreciation for a biopsychosocial approach, which takes in multiple facets of a patient presentation, may significantly impact this increase. To the best our knowledge, there are no studies evaluating the relationship between the STarTBack Screening Tool (SBT) and the access point the patient enters the health system. Our hypothesis is that patients that access care through the medical model will exhibit greater psychosocial risk.
Methods: A retrospective analysis of 1404 cases of LBP utilizing past medical history, demographic information, and SBT data. A linear regression model to identify potential predictors was utilized followed by analyses using cumulative logistic regression model with potential predictors.
Results: Referral source had a positive impact on the SBT score and higher probability of high risk classification. Compared to direct access, accessing care through a primary care physician had an odds ratio of 2.802 and specialist an odds ratio of 3.195.
Conclusion: This study provides evidence to the impact that access may have on the psychosocial status of patients with LBP. The approach taken by the healthcare provider may impact long term pain and functional outcomes and costs.
Keywords: Low Back Pain, Direct Access, Health Systems