Rural-Urban Disparities in the Surgical Treatment of Carpal Tunnel Syndrome in the United States

Brandon Earp ^1,2, Philip Blazar ^1,2, Dafang Zhang ^1,2

⁰Orthopaedic Surgery, Brigham and Women's Hospital, Boston, USA.

Cureus +

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August 29, 2024

View abstract on PubMed

Summary

Rural patients undergoing carpal tunnel release (CTR) are more likely to have electrodiagnostic study (EDS)-negative disease. This finding questions the utility of EDS testing in this population and highlights the need for equitable rural healthcare.

Area Of Science

Orthopedic Surgery
Health Services Research
Rural Health Equity

Background

Rural populations face disparities in healthcare access and quality.
Policy initiatives aim to reduce rural-urban health inequities.
Carpal tunnel release (CTR) is a common surgical procedure.

Purpose Of The Study

To compare demographic factors, electrodiagnostic study (EDS) utilization, and preoperative EDS severity between rural and urban patients undergoing CTR.
To identify potential disparities in diagnostic testing and preoperative assessment for CTR between rural and urban populations.

Main Methods

Retrospective analysis of 1,138 patients undergoing CTR.
Classification of patients as rural or urban using Rural-Urban Commuting Area (RUCA) codes.
Multivariable logistic regression to identify associations between rural residence and outcome variables.

Main Results

No significant difference in EDS testing utilization between rural and urban patients.
Rural residence was associated with older age, lower BMI, and EDS-negative disease.
EDS-negative disease was more prevalent in rural patients undergoing CTR.

Conclusions

Rural patients undergoing CTR are more likely to present with EDS-negative findings.
The effectiveness of EDS testing as a confirmatory tool for CTR in rural populations warrants further investigation.
Additional research is necessary to ensure equitable care for rural populations undergoing CTR.

Keywords:

carpal tunnel syndrome global healthcare systems health disparity rural health rural-urban disparity