Nuckols Teryl, Conlon Craig, Robbins Michael, Dworsky Michael, Lai Julie, Roth Carol P, Levitan Barbara, Seabury Seth, Seelam Rachana, Asch Steven M
RAND 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.
J Occup Environ Med. 2017 Jan;59(1):47-53. doi: 10.1097/JOM.0000000000000916.
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.
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.
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.
Care processes for work-associated CTS frequently adhered to quality measures. Clinical factors were more strongly associated with quality than demographic and socioeconomic ones.
评估为与腕管综合征（CTS）相关的工伤赔偿个体提供的护理质量，并确定与获得更好护理相关的患者特征。
我们从北加利福尼亚州凯撒医疗集团下属的30家职业诊所招募了新诊断为CTS的受试者。我们对477名受试者的病历应用了45项以过程为导向的质量指标，并进行多因素逻辑回归分析以确定与质量相关的患者特征。
总体而言，81.6%的护理符合推荐标准。某些与评估和管理活动相关的任务未得到充分利用。具有典型/可能的卡茨图表、阳性电诊断测试结果和较高收入的患者获得了更好的护理。然而，年龄、性别和种族/民族与护理质量无关。
与工作相关的CTS的护理过程经常符合质量指标。临床因素比人口统计学和社会经济因素与护理质量的关联更强。
