{ "abstract": "Hospital-based spine-related diagnoses in children are often preceded by substantial healthcare use, but patterns and determinants remain poorly understood. This study aimed to describe pre-hospital primary healthcare use according to parental spine-related hospital diagnoses, the child's comorbidity burden, and household income. We conducted a nationwide, registry-based cohort study including all Danish children aged 2-17 years with a first hospital-based spine-related diagnosis between 2009 and 2022 (n = 46,497). Healthcare services with general practitioners (GP), chiropractors, physiotherapists, and office-based specialist providers in the two years prior to diagnosis were quantified. Primary healthcare use was described across age groups, parental spine-related hospital diagnoses, the child's comorbidity burden, and income tertiles. In the two years before diagnosis, children had a median of 9 reimbursed GP services (IQR [5-17]), 0 chiropractor services [0-0], 0 physiotherapy services [0-0], and 0 office-based specialist services [0-1]. GP use was common, whereas use of non-GP providers was highly skewed, with most children having no or few reimbursed services and a smaller subgroup having repeated service use. Descriptive patterns of healthcare use varied according to parental spine-related hospital diagnoses and comorbidity burden. Healthcare use showed no clear descriptive gradient across household income groups.Conclusion\n\nPatterns of primary healthcare use varied according to parental spine-related hospital diagnoses and comorbidity burden. No clear overall income gradient was observed, although patterns varied by provider type. These findings describe heterogeneous pre-hospital primary healthcare use in this population.What is known\n\n• Spinal pain is common in children and is associated with substantial burden, including school absence and later risk of chronic pain. • Hospital-based spinal diagnoses in children are increasingly non-specific and often represent conditions that could be managed in primary care.What is new\n\n• Higher primary healthcare use was observed among children with greater comorbidity burden and among those with parental spine-related hospital diagnoses. • Differences in total primary healthcare use across household income groups were small, with no clear income gradient.", "abstract_shown": true, "affiliations": [ "Medical Spinal Research Unit, Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Sygehusvej 24, 6000, Kolding, Denmark. Freja.gomez.overgaard@rsyd.dk.", "Department of Regional Health Research, University of Southern Denmark, Odense, Denmark. Freja.gomez.overgaard@rsyd.dk.", "Department of Chiropractic, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, Australia. Freja.gomez.overgaard@rsyd.dk.", "Department of Chiropractic, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, Australia.", "Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.", "Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.", "Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.", "The Chiropractic Knowledge Hub, Odense, Denmark.", "Medical Spinal Research Unit, Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Sygehusvej 24, 6000, Kolding, Denmark.", "Department of Regional Health Research, University of Southern Denmark, Odense, Denmark." ], "article_type": "research article", "arxiv": null, "author_total": 7, "authors": [ { "affs": [ 0, 1, 2 ], "name": "Freja Gomez Overgaard", "orcid": "0009-0008-0367-0823" }, { "affs": [ 3 ], "name": "Michael Swain" }, { "affs": [ 4, 5 ], "name": "Mette Wod" }, { "affs": [ 6, 7 ], "name": "Lise Hestbæk" }, { "affs": [ 6 ], "name": "Henrik Hein Lauridsen" }, { "affs": [ 8, 9 ], "name": "Søren Francis Dyhrberg O'Neill" }, { "affs": [ 8, 9 ], "name": "Casper Nim" } ], "bibtex": "https://research.draconitic.com/paper/afvcek9amm8pv.bib", "cited_by": 0, "doi": "10.1007/s00431-026-07540-y", "fulltext_url": "https://europepmc.org/articles/PMC13719717", "id": "afvcek9amm8pv", "issns": [ "0340-6199", "1432-1076" ], "landing_url": "https://europepmc.org/article/MED/42955406", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Research" ], [ "openalex", "2736|Musculoskeletal pain and rehabilitation" ] ], "openalex": "W7224480477", "pdf_url": "https://europepmc.org/articles/PMC13719717?pdf=render", "pmcid": "PMC13719717", "pmid": "42955406", "published": "2026-10-29", "publisher": null, "ris": "https://research.draconitic.com/paper/afvcek9amm8pv.ris", "sources": [ { "first_seen": "2026-11-01T00:20:36Z", "native_id": "MED:42955406", "source": "europepmc", "url": "https://europepmc.org/article/MED/42955406" }, { "first_seen": "2026-11-02T12:23:38Z", "native_id": "PMC13719717", "source": "pmc", "url": "https://doi.org/10.1007/s00431-026-07540-y" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2736|Musculoskeletal pain and rehabilitation", "subfield": "pharmacology-toxicology" } ], "title": "Primary healthcare use prior to hospital consultations for spinal disorders among Danish children and adolescents: A descriptive nationwide registry-based study.", "title_text": "Primary healthcare use prior to hospital consultations for spinal disorders among Danish children and adolescents: A descriptive nationwide registry-based study.", "type": "peer-reviewed", "updated_at": "2026-11-03T12:20:44Z", "url": "https://research.draconitic.com/paper/afvcek9amm8pv", "venue": "European journal of pediatrics", "versions": [] }