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Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Quality of Care for Work-Associated Carpal Tunnel Syndrome
Teryl Nuckols1, Craig Conlon, Michael Robbins
1RAND Corporation, Santa Monica (Dr Nuckols, Dr Robbins, Dr Dworsky, Ms Lai, Ms Roth, Ms Levitan, Ms Seelam, Dr Asch); Division of General Internal Medicine, Cedars-Sinai Medical Center (Dr Nuckols); Employee Health, The Permanente Medical Group, Oakland (Dr Conlon); University of Southern California, USC Schaeffer Center (Dr Seabury), Los Angeles; VA Palo Alto Health Care System, Menlo Park (Dr Asch); and Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, Palo Alto (Dr Asch), California.
Objective:
To evaluate the quality of care provided to individuals with workers' compensation claims related to Carpal tunnel syndrome (CTS) and identify patient characteristics associated with receiving better care.
Methods:
We recruited subjects with new claims for CTS from 30 occupational clinics affiliated with Kaiser Permanente Northern California. We applied 45 process-oriented quality measures to 477 subjects' medical records, and performed multivariate logistic regression to identify patient characteristics associated with quality.
Results:
Overall, 81.6% of care adhered to recommended standards. Certain tasks related to assessing and managing activity were underused. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
Conclusions:
Care processes for work-associated CTS frequently adhered to quality measures. Clinical factors were more strongly associated with quality than demographic and socioeconomic ones.
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