Background
Methods
Study population
Data sources
Variables
Dependent variable
First healthcare provider type
Independent variables
Predisposing characteristics
Demographic
Social
Workplace
Enabling resources
Financial
Organizational
Needs
Health behavior
Compensation process
Analysis
Results
Description
Individual characteristics | ||
---|---|---|
n or mean | % or SD | |
Predisposing characteristics | ||
Demographic: | ||
Sex; n (%) | ||
Male | 3417 | 61.9 % |
Female | 2103 | 38.1 % |
Age; mean (SD) | 36.6 | 10.9 |
Social: | ||
Language; n (%) | ||
English | 5123 | 92.8 % |
French | 89 | 1.6 % |
Other | 247 | 4.5 % |
Missing | 61 | 1.1 % |
Workplace: | ||
Job tenure (years); mean (SD) (1571 missing) | 7.8 | 8.1 |
Union member; n (%) | ||
Yes | 2819 | 51.1 % |
No | 2625 | 47.6 % |
Missing | 76 | 1.4 % |
Employer doubts the accident is work-related; n (%) | ||
Yes | 592 | 10.7 % |
No | 4193 | 76.0 % |
Missing | 735 | 13.3 % |
Physical demands; n (%) | ||
Manual | 3538 | 64.1 % |
Non-manual | 655 | 11.9 % |
Mixed-manual | 1158 | 21.0 % |
Missing | 169 | 3.1 % |
Sector of economic activity; n (%) | ||
Agriculture-related service | 41 | 0.7 % |
Fishing/trapping | 1 | 0.0 % |
Logging and forestry | 7 | 0.1 % |
Mining, quarrying and oil wells | 15 | 0.3 % |
Manufacturing | 1324 | 24.0 % |
Construction | 278 | 5.0 % |
Transportation and storage | 324 | 5.9 % |
Communication and other utilities | 85 | 1.5 % |
Wholesale trade | 335 | 6.1 % |
Retail trade | 664 | 12.0 % |
Real estate operator or insurance agent | 28 | 0.5 % |
Business service | 189 | 3.4 % |
Government service | 47 | 0.9 % |
Educational service | 30 | 0.5 % |
Health and social service | 717 | 13.0 % |
Accommodation, food and beverage service | 228 | 4.1 % |
Other service | 160 | 2.9 % |
Missing | 1047 | 19.0 % |
Early return to work program; n (%) | ||
Yes | 4437 | 80.4 % |
No | 704 | 12.8 % |
Missing | 379 | 6.9 % |
Number of employees; n (%) | ||
20 or fewer | 1621 | 29.4 % |
More than 20 | 3887 | 70.4 % |
Missing | 12 | 0.2 % |
Enabling resources | ||
Financial: | ||
Gross personal income per year in Canadian dollars; mean (SD) (1 missing) | 37581 | 17016 |
Organizational: | ||
Community size; n (%) | ||
1,500,000+ | 1982 | 35.9 % |
500,000–1,499,999 | 696 | 12.6 % |
100,000–499,999 | 1648 | 29.9 % |
10,000–99,999 | 519 | 9.4 % |
Less than 10,000 | 661 | 12.0 % |
Missing | 14 | 0.3 % |
Urban/rural indicator; n (%) | ||
Rural | 784 | 14.2 % |
Urban | 4716 | 85.4 % |
Missing | 20 | 0.4 % |
Needs | ||
Previous similar injury; n (%) | ||
Yes | 1937 | 35.1 % |
No | 3417 | 61.9 % |
Missing | 166 | 3.0 % |
Previous 100 % wage compensation claim; n (%) | ||
Yes | 2501 | 45.3 % |
No | 3019 | 54.7 % |
Restricted use of public transportation; n (%) | ||
Yes | 44 | 0.8 % |
No | 4823 | 87.4 % |
Missing | 653 | 11.8 % |
Restricted operation of a motor vehicle; n (%) | ||
Yes | 116 | 2.1 % |
No | 4779 | 86.6 % |
Missing | 625 | 11.3 % |
Any task limitations; n (%) | ||
Yes | 3674 | 66.6 % |
No | 1281 | 23.2 % |
Missing | 565 | 10.2 % |
Nature of injury; n (%) | ||
Least severe | 5227 | 94.8 % |
Most severe | 284 | 5.2 % |
Part of body; n (%) | ||
Upper back pain | 492 | 8.9 % |
Low back pain | 4528 | 82.2 % |
Multiple regions | 315 | 5.7 % |
Back pain (unspecified upper or low) | 176 | 3.2 % |
Health behavior | ||
Days between the accident and the first health care consultation; mean (SD) | 2.1 | 3.9 |
First healthcare provider; n (%) | ||
Chiropractor | 627 | 11.4 % |
Physician | 4710 | 85.3 % |
Physiotherapist | 174 | 3.2 % |
Nurse | 9 | 0.2 % |
Compensation process | ||
Days between the accident and the registration of the claim; mean (SD) (1 missing) | 7.7 | 8.3 |
Days between the accident and the approval of the claim; mean (SD) | 32.3 | 58.4 |
Factors associated with the type of first healthcare provider
Bivariate results
Variables | Association with the first healthcare provider | ||||||
---|---|---|---|---|---|---|---|
DC | MD | PT | P-value | ||||
n or mean | % or SD | n or mean | % or SD | n or mean | % or SD | ||
Individual characteristics | |||||||
Predisposing characteristics | |||||||
Demographic: | |||||||
Sex; n (%) | |||||||
Male | 393 | 62.7 % | 2919 | 62.0 % | 100 | 57.5 % | 0.445 |
Female | 234 | 37.3 % | 1791 | 38.0 % | 74 | 42.5 % | |
Age; mean (SD) | 40 | 11 | 39 | 11 | 42 | 10 | 0.002a |
Social: | |||||||
Language; n (%) | |||||||
English or French | 599 | 96.8 % | 4436 | 95.3 % | 168 | 96.6 % | 0.184 |
Other | 20 | 3.2 % | 221 | 4.7 % | 6 | 3.4 % | |
Workplace: | |||||||
Job tenure (years); mean (SD) | 9.5 | 8.9 | 7.6 | 8 | 8.8 | 8.6 | 0.002b |
Union member; n (%) | |||||||
Yes | 341 | 55.0 % | 2381 | 51.3 % | 93 | 53.8 % | 0.193 |
No | 279 | 45.0 % | 2261 | 48.7 % | 80 | 46.2 % | |
Employer doubts the accident is work-related; n (%) | |||||||
Yes | 69 | 13.2 % | 505 | 12.3 % | 16 | 11.0 % | 0.753 |
No | 455 | 86.8 % | 3602 | 87.7 % | 129 | 89.0 % | |
Physical demands; n (%) | |||||||
Manual | 374 | 60.9 % | 3050 | 66.9 % | 110 | 65.1 % | 0.041 |
Non-manual | 81 | 13.2 % | 548 | 12.0 % | 24 | 14.2 % | |
Mixed-manual | 159 | 25.9 % | 962 | 21.1 % | 35 | 20.7 % | |
Sector of economic activity; n (%) | |||||||
Agriculture, fishing/trapping, logging and forestry, mining, quarrying and oil wells | 5 | 1.0 % | 56 | 1.5 % | 3 | 2.2 % | 0.503 |
Manufacturing | 139 | 29.1 % | 1147 | 29.8 % | 37 | 27.4 % | |
Construction | 31 | 6.5 % | 243 | 6.3 % | 4 | 3.0 % | |
Transportation and storage | 35 | 7.3 % | 280 | 7.3 % | 7 | 5.2 % | |
Communication and other utility | 9 | 1.9 % | 74 | 1.9 % | 2 | 1.5 % | |
Wholesale trade | 37 | 7.7 % | 288 | 7.5 % | 10 | 7.6 % | |
Retail trade | 76 | 15.9 % | 566 | 14.7 % | 21 | 15.6 % | |
Real estate operator or insurance agent | 1 | 0.2 % | 26 | 0.7 % | 1 | 0.7 % | |
Business service | 18 | 3.8 % | 163 | 4.2 % | 8 | 5.9 % | |
Government service | 10 | 2.1 % | 33 | 0.9 % | 3 | 2.2 % | |
Educational service | 1 | 0.2 % | 29 | 0.8 % | 0 | 0.0 % | |
Health and social service | 80 | 16.7 % | 606 | 15.7 % | 30 | 22.2 % | |
Accommodation, food and beverage service | 19 | 4.0 % | 205 | 5.3 % | 4 | 3.0 % | |
Other service | 17 | 3.6 % | 137 | 3.6 % | 5 | 3.7 % | |
Early return to work program; n (%) | |||||||
Yes | 502 | 84.2 % | 3783 | 86.5 % | 144 | 88.3 % | 0.235 |
No | 94 | 15.8 % | 590 | 13.5 % | 19 | 11.7 % | |
Number of employees; n (%) | |||||||
20 or fewer | 210 | 33.6 % | 1359 | 28.9 % | 50 | 29.1 % | 0.053 |
More than 20 | 415 | 66.4 % | 3343 | 71.1 % | 122 | 70.9 % | |
Enabling resources | |||||||
Financial: | |||||||
Gross personal income per year ($CAN); mean (SD) | 40054 | 17300 | 37173 | 16948 | 39732 | 17021 | <0.001c |
Organizational: | |||||||
Community size; n (%) | |||||||
1,500,000 + | 185 | 29.6 % | 1719 | 36.6 % | 77 | 44.3 % | <0.001 |
500,000–1,499,999 | 60 | 9.6 % | 614 | 13.1 % | 20 | 11.5 % | |
100,000–499,999 | 207 | 33.1 % | 1395 | 29.7 % | 44 | 25.3 % | |
10,000–99,999 | 78 | 12.5 % | 424 | 9.0 % | 16 | 9.2 % | |
Less than 10,000 | 96 | 15.3 % | 545 | 11.6 % | 17 | 9.8 % | |
Urban/rural indicator; n (%) | |||||||
Rural | 105 | 16.8 % | 657 | 14.0 % | 20 | 11.5 % | 0.098 |
Urban | 520 | 83.2 % | 4035 | 86.0 % | 154 | 88.5 % | |
Needs | |||||||
Previous similar injury; n (%) | |||||||
Yes | 288 | 47.1 % | 1565 | 34.3 % | 83 | 48.3 % | <0.001 |
No | 323 | 52.9 % | 2997 | 65.7 % | 89 | 51.7 % | |
Previous 100 % wage compensation claim; n (%) | |||||||
Yes | 301 | 48.0 % | 2112 | 44.8 % | 86 | 49.4 % | 0.179 |
No | 326 | 52.0 % | 2598 | 55.2 % | 88 | 50.6 % | |
Restricted use of public transportation; n (%) | |||||||
Yes | 6 | 1.2 % | 38 | 0.9 % | 0 | 0.0 % | 0.432 |
No | 510 | 98.8 % | 4165 | 99.1 % | 142 | 100.0 % | |
Restricted operation of a motor vehicle; n (%) | |||||||
Yes | 8 | 1.6 % | 106 | 2.5 % | 2 | 1.4 % | 0.306 |
No | 503 | 98.4 % | 4127 | 97.5 % | 142 | 98.6 % | |
Any task limitations; n (%) | |||||||
Yes | 402 | 77.5 % | 3160 | 73.8 % | 107 | 72.8 % | 0.182 |
No | 117 | 22.5 % | 1123 | 26.2 % | 40 | 27.2 % | |
Nature of injury; n (%) | |||||||
Least severe | 581 | 92.7 % | 4488 | 95.3 % | 158 | 90.8 % | 0.001 |
Most severe | 46 | 7.3 % | 222 | 4.7 % | 16 | 9.2 % | |
Part of body; n (%) | |||||||
Upper back pain | 53 | 8.5 % | 246 | 9.0 % | 13 | 7.5 % | 0.494 |
Low back pain | 522 | 83.3 % | 3859 | 81.9 % | 147 | 84.5 % | |
Multiple regions | 40 | 6.4 % | 267 | 5.7 % | 8 | 4.6 % | |
Back pain (unspecified upper or low) | 12 | 1.9 % | 158 | 3.4 % | 6 | 3.4 % | |
Health behavior | |||||||
Days between the accident and the first health care consultation; mean (SD) | 2.3 | 3.8 | 2 | 3.7 | 5.1 | 6.4 | <0.001d |
Additional type of care sought within the first 4 weeks; n (%) | |||||||
Chiropractor | − | − | 507 | 10.8 % | 3 | 1.7 % | <0.001* |
Physician | 144 | 23.0 % | − | − | 102 | 58.6 % | |
Physiotherapist | 25 | 4.0 % | 1213 | 25.8 % | − | − | |
No additional type of care | 476 | 75.9 % | 3026 | 64.2 % | 70 | 40.2 % | |
Compensation process | |||||||
Days between the accident and the registration of the claim; mean (SD) | 8.9 | 9.7 | 7.5 | 8.1 | 9.1 | 8.3 | <0.001e |
Days between the accident and the approval of the claim; mean (SD) | 43 | 100 | 31 | 51 | 37 | 50 | <0.001f |
Multivariable results
DC vs MD | PT vs MD | PT vs DC | |||||||
---|---|---|---|---|---|---|---|---|---|
(n = 5337) | (n = 4721) | (n = 800) | |||||||
OR | 95 % CI | P-value | OR | 95 % CI | P-value | OR | 95 % CI | P-value | |
Predisposing characteristics | |||||||||
Demographic: | |||||||||
Sex (male) | − | − | − | 0.78 | (0.57 to 1.07) | 0.130 | 0.71 | (0.49 to 1.04) | 0.080 |
Age (10 years) | 0.94 | (0.85 to 1.03) | 0.157 | 1.19 | (1.03 to 1.38) | 0.019 | 1.28 | (1.07 to 1.54) | 0.008 |
Workplace: | |||||||||
Job tenure (years) | 1.02 | (1.01 to 1.03) | 0.004 | − | − | − | 0.98 | (0.96 to 1.01) | 0.229 |
Physical demands | |||||||||
Manual | Reference | − | − | − | reference | ||||
Non-manual | 1.23 | (0.95 to 1.61) | 0.115 | − | − | − | 0.80 | (0.46 to 1.37) | 0.412 |
Mixed-manual | 1.35 | (1.10 to 1.65) | 0.004 | − | − | − | 0.63 | (0.40 to 0.99) | 0.044 |
Early return to work program (yes) | 0.77 | (0.61 to 0.98) | 0.035 | − | − | − | − | − | − |
Enabling resources | |||||||||
Financial: | |||||||||
Gross personal income per year ($10,000) | 1.06 | (1.01 to 1.12) | 0.018 | 1.06 | (0.97 to 1.16) | 0.205 | − | − | − |
Organizational: | |||||||||
Community size (inhabitants) | |||||||||
1,500,000+ | 0.66 | (0.50 to 0.86) | 0.002 | 1.50 | (0.88 to 2.55) | 0.142 | 2.58 | (1.42 to 4.67) | 0.002 |
500,000–1,499,999 | 0.58 | (0.41 to 0.82) | 0.002 | 1.10 | (0.57 to 2.10) | 0.787 | 1.98 | (0.95 to 4.12) | 0.069 |
100,000–499,999 | 0.88 | (0.67 to 1.14) | 0.332 | 1.03 | (0.63 to 1.68) | 0.912 | 1.26 | (0.68 to 2.33) | 0.472 |
10,000–99,999 | 1.09 | (0.78 to 1.51) | 0.621 | 1.22 | (0.70 to 2.13) | 0.575 | 1.23 | (0.58 to 2.61) | 0.597 |
Less than 10,000 | reference | reference | reference | ||||||
Needs | |||||||||
Previous similar injury (yes) | 1.60 | (1.34 to 1.90) | <0.001 | 1.71 | (1.25 to 2.33) | 0.001 | − | − | − |
Any task limitations (yes) | 1.18 | (0.95 to 1.48) | 0.135 | − | − | − | − | − | − |
Nature of injury (more severe) | 1.39 | (0.99 to 1.96) | 0.054 | 2.03 | (1.21 to 3.41) | 0.010 | 1.49 | (0.80 to 2.78) | 0.205 |
Part of body | |||||||||
Upper back pain | reference | − | − | − | − | − | − | ||
Low back pain | 1.01 | (0.75 to 1.38) | 0.928 | − | − | − | − | − | − |
Multiple regions | 1.19 | (0.76 to 1.86) | 0.447 | − | − | − | − | − | − |
Back pain (unspecified upper or low) | 0.60 | (0.31 to 1.16) | 0.127 | − | − | − | − | − | − |
Constant | 0.12 | (0.07 to 0.20) | <0.001 | 0.01 | (0.01 to 0.02) | <0.001 | 0.10 | (0.04 to 0.23) | <0.001 |
Area under the ROC curve | 0.62 | (0.60 to 0.65) | <0.001 | 0.63 | (0.59 to 0.67) | <0.001 | 0.64 | (0.60 to 0.69) | <0.001 |