Using a behavioral model to identify factors associated with choice of provider for neck and low back pain: A systematic review

Abstract

BackgroundIt remains unclear as to what factors influence a patient's choice to seek care from a specific healthcare provider for low back and neck pain. ObjectiveUtilize Andersen's Behavioral Model of Health Service Utilization as a conceptual framework to identify the predisposing, enabling and need factors associated with choice of healthcare provider for back and/or neck pain. MethodsPubMed, CINAHL, EMBASE, and SCOPUS databases were searched for studies that included 1) patients seeking care for acute or chronic low back or neck pain; 2) patients at least 18 years of age; 3) reported any healthcare provider type chosen to be seen. Significant factors addressing a patient's choice of provider seen for back pain, neck pain, or both were extracted from studies and analyzed under the Behavioral Model of Health Service Utilization. Results20 studies were included in this review: 17 quantitative studies and 3 qualitative studies. Provider types identified were medical physicians, chiropractors, physical therapists, acupuncturists and CAM providers. Age and sex were the most commonly reported predisposing factors; financial and personal factors were the most common enabling factors; patients’ duration of pain and self-reported level of functioning were the most commonly reported need factors. ConclusionsWhile predisposing and need factors are important, enabling factors also have an influence in choice of healthcare provider for back and/or neck pain.