Patients with back pain receive quite different care from different types of health care practitioners.
We performed a prospective observational study to determine whether the outcomes of and charges for care differ among primary care practitioners, chiropractors, and orthopedic surgeons.
Two hundred eight practitioners in North Carolina were randomly selected from six strata : urban primary care physicians (n=39), rural primary care physicians (n=48), urban chiropractors (n=32), rural chiropractors (n=32), orthopedic surgeons (n=29), and primary care providers at a group-model health maintenance organization (HMO) (n=28).
The practitioners enrolled consecutive patients with acute low back pain.
The patients were contacted by telephone periodically for up to 24 weeks to assess functional status, work status, use of health care services, and satisfaction with the care received.
The status at six months was ascertained for 1555 of the 1633 patients enrolled in the study (95 percent).
Among patients with acute low back pain, the outcomes are similar whether they receive care from primary care practitioners, chiropractors, or orthopedic surgeons.
Primary care practitioners provide the least expensive care for acute low back pain.
(N Engl J Med 1995 ; 333 : 913-7.).
Mots-clés Pascal : Douleur, Rachis, Aigu, Economie santé, Analyse coût efficacité, Système santé, Médecin généraliste, Chirurgien, Etats Unis, Traitement, Evaluation, Adulte, Etude comparative, Amérique du Nord, Amérique, Homme, Système ostéoarticulaire pathologie, Rachis pathologie
Mots-clés Pascal anglais : Pain, Spine, Acute, Health economy, Cost efficiency analysis, Health system, General practitioner, Surgeon, United States, Treatment, Evaluation, Adult, Comparative study, North America, America, Human, Diseases of the osteoarticular system, Spine disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0570701
Code Inist : 002B30A01B. Création : 01/03/1996.