Emergency Department Presentations for Low Back Pain by Remoteness and Socioeconomic Status in New South Wales: A Population-Based Study

Abstract

Objective

To explore the patterns of emergency department (ED) presentations for low back pain (LBP) by remoteness and socioeconomic status (SES) in New South Wales (NSW).

Methods

A retrospective, population-based study of deidentified data was undertaken with data sourced from the NSW Emergency Department Data Collection (EDDC). The study population comprised NSW residents who presented to an NSW public hospital ED in 2013–2019 for LBP and were registered in the NSW EDDC. Total LBP ED presentations, quasi-Poisson regression modelled annual changes in LBP ED presentations over 2013–2019, and age and sex-standardised rates of ED presentations in 2019 were assessed.

Results

Overall, between 2013 and 2019, LBP ED presentations increased in both metropolitan and rural NSW, with mean annual percentage increases of 3.5% (95% CI 2.9–4.0) and 4.7% (95% CI 3.6–5.9), respectively. Rates of LBP ED presentations increased with decreasing SES in both metropolitan and rural areas. Rates of LBP ED presentations were higher in rural areas compared to metropolitan NSW across all SES quintiles.

Conclusions

Remoteness and SES were independently associated with rates of LBP ED presentations. Further research on the underlying causal mechanisms linking rates of LBP to each of these key sociodemographic factors is warranted. Elucidating these mechanisms would provide crucial information to inform strategies to reduce the rates and impacts of LBP presentations in EDs and help counteract social determinants of health.