Satisfaction with low back pain care

Background: By using a unique, prospective study of occupational back pain claims, we examined health-care satisfaction by provider type and its effect on return to work. Purpose: We estimated satisfaction differentials by provider type, decomposing overall satisfaction into two components: bedside manner and effectiveness of care. We also examined how health-care satisfaction affects the duration of jobless claims. Study design: The Arizona State University Healthy Back Study (HBS) is a prospective study of work-related back pain; 1,831 workers completed a baseline interview, with follow-up interviews at 1 month, 6 months, and 1 year. The HBS merged demographic and claim characteristics from the workers' compensation claim files with self-reported severity measures, measures of satisfaction, and postonset employment from worker interviews. Outcome measures: Overall and detailed satisfaction with treatment and workers' compensation claim duration. Methods: We performed a nonparametric descriptive analysis of satisfaction by provider type and used multivariate regressions to decompose overall satisfaction into component parts. The duration analysis links differentials in health care satisfaction to differences in claim durations. Results: Workers treated by surgeons, chiropractors (DCs), or physical therapists are more satisfied with their health care than those treated by MDs. Workers are more concerned with the effectiveness of care than with the bedside manner of their provider. A one standard deviation improvement in satisfaction with the health-care provider reduces claim duration by about 25%. Conclusions: Satisfaction with health care has a significant impact on jobless spells and varies significantly between provider types.