Mr Joseph Orlando1,2, Mr Matthew Beard1, Prof Anne Burke1,3,4, Dr Michelle Guerin2, Prof Saravana Kumar2
1Central Adelaide Local Health Network, Adelaide, Australia, 2IIMPACT in Health, Allied Health & Human Performance, University of South Australia, Adelaide, Australia, 3Commission on Excellence and Innovation in Health, Government of South Australia, Adelaide, Australia, 4School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
Biography:
Joseph Orlando is an advanced practice physiotherapist working in the Emergency Department, Spinal Assessment Clinics, and Pain Management Unit of the Central Adelaide Local Health Network. He is undertaking a Higher Degree by Research with the University of South Australia. His research interests include telehealth, health service evaluation, and optimal care for low back pain.
Abstract:
Background and Aims:
Hospital admissions for non-specific low back pain (LBP) are costly, strain hospital resources, and often expose patients unnecessary spinal imaging and strong opioid analgesics. This study explored factors that contribute to LBP-related hospitalisations to improve the delivery of healthcare for LBP.
Methods:
Mixed-methods research was undertaken. Part 1 comprised an observational study set across six South Australian public hospitals over a five-year period. Patient data relating to emergency department (ED) presentations for LBP were extracted from electronic medical records and analysed to measure associations between identified variables and hospitalisation. Part 2 comprised semi-structured interviews with 16 patients admitted to hospital for LBP. Using qualitative descriptive methodology, interviews were analysed for themes to summarise the experiences of patients that led to hospitalisation.
Results:
Part 1: There were 11,709 presentations to ED for LBP across the study period, and 27.2% resulted in hospital admissions. Factors associated with hospital admission included older age, ambulance arrival, and ordering certain investigations in the ED. Hospitalisation rates for LBP were lower in regional hospitals and in Indigenous Australians.
Part 2: Patients identified two overarching themes that preceded their experiences prior to hospitalisation, including significant impact of LBP, and unmet treatment needs and expectations.
Conclusions:
This study identified patient and health system factors that contributed to LBP-related hospitalisations. The findings are an opportunity for co-design of community healthcare services to improve the delivery and access of care for LBP. Further investigation is required on whether certain LBP-related hospital admissions can be prevented.