Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases
Abstract Background A different utilization of health care services due to socioeconomic status on the same health plan contradicts the principle of equal treatment. We investigated the presence and magnitude of socioeconomic differences in utilization of diagnostic imaging and non-pharmaceutical co...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06909-6 |
| _version_ | 1797578619087749120 |
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| author | Falko Tesch Jochen Schmitt Patrik Dröge Christian Günster Andreas Seidler Johannes Flechtenmacher Burkhard Lembeck Bernd Kladny Dieter Christian Wirtz Fritz-Uwe Niethard Toni Lange |
| author_facet | Falko Tesch Jochen Schmitt Patrik Dröge Christian Günster Andreas Seidler Johannes Flechtenmacher Burkhard Lembeck Bernd Kladny Dieter Christian Wirtz Fritz-Uwe Niethard Toni Lange |
| author_sort | Falko Tesch |
| collection | DOAJ |
| description | Abstract Background A different utilization of health care services due to socioeconomic status on the same health plan contradicts the principle of equal treatment. We investigated the presence and magnitude of socioeconomic differences in utilization of diagnostic imaging and non-pharmaceutical conservative therapies for patients with spinal diseases. Methods The cohort study based on routine healthcare data from Germany with 11.7 million patient-years between 2012 and 2016 for patients with physician-confirmed spinal diseases (ICD-10: M40-M54), occupation and age 20 to 64 years. A Poisson model estimated the effects of the socioeconomic status (school education, professional education and occupational position) for the risk ratio of receiving diagnostic imaging (radiography, computed tomography, magnetic resonance imaging) and non-pharmaceutical conservative therapies (physical therapy including exercise therapy, manual therapy and massage, spinal manipulative therapy, acupuncture). Results Patients received diagnostic imaging in 26%, physical therapy in 32%, spinal manipulative therapy in 25%, and acupuncture in 4% of all patient-years. Similar to previous survey-based studies higher rates of utilization were associated with higher socioeconomic status. These differences were most pronounced for manual therapy, exercise therapy, and magnetic resonance imaging. Conclusions The observed differences in health care utilization were highly related to socioeconomic status. Socioeconomic differences were higher for more expensive health services. Further research is necessary to identify barriers to equitable access to health services and to take appropriate action to decrease existing social disparities. |
| first_indexed | 2024-03-10T22:25:21Z |
| format | Article |
| id | doaj.art-acd8796676e241ff992ec74f6f00732c |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-10T22:25:21Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-acd8796676e241ff992ec74f6f00732c2023-11-19T12:08:45ZengBMCBMC Musculoskeletal Disorders1471-24742023-10-012411910.1186/s12891-023-06909-6Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseasesFalko Tesch0Jochen Schmitt1Patrik Dröge2Christian Günster3Andreas Seidler4Johannes Flechtenmacher5Burkhard Lembeck6Bernd Kladny7Dieter Christian Wirtz8Fritz-Uwe Niethard9Toni Lange10Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU DresdenCenter for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU DresdenAllgemeine Ortskrankenkasse (AOK) Research InstituteAllgemeine Ortskrankenkasse (AOK) Research InstituteInstitute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, TU DresdenGerman Professional Association for Orthopedics and Trauma SurgeryGerman Professional Association for Orthopedics and Trauma SurgeryDepartment of Orthopedics and Trauma Surgery, m&i Fachklinik HerzogenaurachDepartment of Orthopedics and Trauma Surgery, University Hospital BonnGerman Professional Association for Orthopedics and Trauma SurgeryCenter for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU DresdenAbstract Background A different utilization of health care services due to socioeconomic status on the same health plan contradicts the principle of equal treatment. We investigated the presence and magnitude of socioeconomic differences in utilization of diagnostic imaging and non-pharmaceutical conservative therapies for patients with spinal diseases. Methods The cohort study based on routine healthcare data from Germany with 11.7 million patient-years between 2012 and 2016 for patients with physician-confirmed spinal diseases (ICD-10: M40-M54), occupation and age 20 to 64 years. A Poisson model estimated the effects of the socioeconomic status (school education, professional education and occupational position) for the risk ratio of receiving diagnostic imaging (radiography, computed tomography, magnetic resonance imaging) and non-pharmaceutical conservative therapies (physical therapy including exercise therapy, manual therapy and massage, spinal manipulative therapy, acupuncture). Results Patients received diagnostic imaging in 26%, physical therapy in 32%, spinal manipulative therapy in 25%, and acupuncture in 4% of all patient-years. Similar to previous survey-based studies higher rates of utilization were associated with higher socioeconomic status. These differences were most pronounced for manual therapy, exercise therapy, and magnetic resonance imaging. Conclusions The observed differences in health care utilization were highly related to socioeconomic status. Socioeconomic differences were higher for more expensive health services. Further research is necessary to identify barriers to equitable access to health services and to take appropriate action to decrease existing social disparities.https://doi.org/10.1186/s12891-023-06909-6Spinal diseasesBack painRoutine healthcare dataHealthcare disparities |
| spellingShingle | Falko Tesch Jochen Schmitt Patrik Dröge Christian Günster Andreas Seidler Johannes Flechtenmacher Burkhard Lembeck Bernd Kladny Dieter Christian Wirtz Fritz-Uwe Niethard Toni Lange Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases BMC Musculoskeletal Disorders Spinal diseases Back pain Routine healthcare data Healthcare disparities |
| title | Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases |
| title_full | Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases |
| title_fullStr | Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases |
| title_full_unstemmed | Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases |
| title_short | Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases |
| title_sort | socioeconomic differences in the utilization of diagnostic imaging and non pharmaceutical conservative therapies for spinal diseases |
| topic | Spinal diseases Back pain Routine healthcare data Healthcare disparities |
| url | https://doi.org/10.1186/s12891-023-06909-6 |
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