• Spine J · Sep 2009

    Comfortably numb? Exploring satisfaction with chronic back pain visits.

    • Andrea S Wallace, Janet K Freburger, Jane D Darter, Anne M Jackman, and Timothy S Carey.
    • University of New Mexico, College of Nursing, MSC 09 5350, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA. aswallace@salud.unm.edu
    • Spine J. 2009 Sep 1; 9 (9): 721-8.

    Background ContextChronic back pain is a condition characterized by high rates of disability, health-care service use, and costs.PurposeThe purpose of this study was to identify factors associated with patients' satisfaction with their last health-care provider visit for chronic low back pain (LBP).Study Design/SettingA cross-sectional, state-level, telephone survey was administered to patients with chronic LBP.Patient SampleThe sample consisted of 624 individuals with chronic LBP who reported seeing a health-care provider in the previous year.Outcome MeasuresDependent variables included satisfaction with last visit for LBP and intent to seek care from additional providers. Independent variables included the Roland-Morris Disability Questionnaire, 3-month pain ratings using a 0 to 10 Likert scale, the Medical Outcomes Survey Short Form 12, and self-reported health service utilization (provider type, number of visits to health-care providers, medication use during the previous month, and treatments and diagnostic tests during the previous year).MethodsBivariate and multivariate analyses were used to explore how demographic, insurance-related, and health-related characteristics were associated with patient satisfaction.ResultsParticipants who were not satisfied with one or more aspects of their last clinic visit were younger (51.0 vs. 54.21 years), reported higher 3-month pain ratings (7.23 vs. 6.53), and were more commonly Hispanic (53.2% vs. 46.8% for other ethnicities) and uninsured (43.1% vs. 29.3% for other insurance groups). Those who intended to seek care from additional providers were younger (50.05 vs. 55.49 years), had higher 3-month pain ratings (7.20 vs. 6.46), had lower Short Form 12 mental health component scores (44.75 vs. 49.55) and physical component scores (30.07 vs. 31.55), and were more commonly black (54.6% vs. 45.4% for other racial groups) and uninsured (56.9% vs. 43.1% for other insurance groups). Narcotic use was associated with satisfaction (odds ratio=2.12, p=.01), whereas lack of insurance was associated with respondents' intent to seek care from additional providers (odds ratio=2.97, p<.01).ConclusionsFactors other than disability were associated with satisfaction with chronic LBP visits. Understanding the role of medication in satisfaction and its implications for the health behaviors of this highly disabled population may be particularly important.

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