Low-back pain is one of the most prevalent and costly problems facing the US health-care system. Although it is the second most frequent primary complaint reported by patients seeking medical care, there is a dearth of population-base research on the utilization of health services for low-back pain. The major purpose of this study is to assess how health services utilization differs among persons with low-back conditions, primarily low-back pain and sciatica. The study's specific aim is to assess the relationship between potential risk factors for use of health services for low-back conditions and reported utilization. The predictors are sociodemographic variables, type of low-back pain onset, type of low-back condition, previous low-back pain, disability status, general health status, other health care, and insurance status. The study will use data collected from the 1989 National Health Interview Survey (NHIS). The NHIS is an ongoing, annual survey that provides data regarding about 49,000 different US households (including about 132,000 individuals). The resulting sample is fully representative of the civilian noninstitutionalized population of the US in 1989. The project is composed of a cross-sectional analysis of subjects who had at least one disability day due to a low-back condition during the 2-week period preceding the week of the interview, comparing use of low-back- related health care and type of health care (if any) among low-back sufferers within each predictor (exposure) group. Predictors will be assessed for both low-back-related health care utilization in general and type of health care utilization among users. This will be the first study using a representative sample of the civilian noninstitutionalized US population to compare recipients of low- back-related care from various specialties and non-recipients with respect to potential determinants of care. The results of this study will provide valuable information about the role of health care and its components on the treatment of a major public-health problem. The results will be invaluable for individuals in all segments of the system, including patients, providers, third-party payors, employers, policymakers, and politicians.
