Health-care access and utilization among individuals with low back pain in Iran: a WHO-ILAR COPCORD study
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RESEARCH ARTICLE
Open Access
Health-care access and utilization among individuals with low back pain in Iran: a WHO-ILAR COPCORD study Seyedeh Tahereh Faezi1, Azarakhsh Baghdadi1,2* , Mohammad Nejadhosseinian1, Maziar Moradi-Lakeh3, Mir Saeed Yekaninejad4, Kourosh Holakoui4, Nasrin Moghimi5, Mahnaz Sandoughi6, Ali Dehghan7, Arash Tehrani Banihashemi8, Maryam Ghadimi2 and Fereydoun Davatchi1
Abstract Background: Low back pain (LBP) is a major contributor to chronic pain and disability. The purpose of this study was to evaluate health-care access and utilization among patients with LBP in Iran. We also sought to study the pattern and characteristics of care-utilization behavior in these patients. Methods: Data from the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) were used for this study. Three cities (Zahedan, Sanandaj, Yazd) were selected to represent the Iranian population, with different socioeconomic status and ethnic, cultural, and religious background. Demographic data, acute or chronic LBP, disability index, and utilizing care from conventional medicine (CM), allied health providers (AHP), and complementary and alternative medicine (CAM) providers were recorded. Results: Of 9101 patients, 38.6% reported LBP. Only 3.3% did not utilize care of any kind, 66.7% referred to CM providers, 20.8% to AHP, and 9.2% to CAM care. Health-care utilization was higher in female patients, older age, higher education, and higher disability index. Conclusions: The findings of this study indicate a high rate of health-care utilization among patients with LBP in Iran. CM is the most prevalent health-care resource sought by patients. These findings could be used as a framework in developing more efficient health-care programs according to the needs of specific populations. Keywords: Low back pain, Rheumatologic diseases, Health-care access, COPCORD, Epidemiology, Public health
Background Low back pain (LBP) is one of the most common symptoms experienced by people of all ages globally [1]. A specific identifiable neurological disorder (e.g., myelopathy) is found only in 10 % of individuals, with the vast majority of patients suffering from non-specific low back pain [2]. The results of the Global Burden of Disease * Correspondence: [email protected] 1 Rheumatology Research center, Tehran University of Medical Sciences, North Amirabad street, Tehran 1411713137, Iran 2 Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA Full list of author information is available at the end of the article
Study 2017 indicate that LBP is the leading cause of years lived with disability in 126 of the 195 countries that study. Also, nearly 540 million people are affected by LBP at any point in time. Further, LBP caused 65 million life-years lost in the same year, with an increase of 30% from 1990 [3]. In 2015, LBP and neck pain were the fourth leading cause of disability-adjusted life years (DALYs) globally [4]. Low- and middle-i
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