Department of Occupational Therapy, Tufts University, Medford, MA; Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA.
Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA.
Arch Phys Med Rehabil. 2019 Sep;100(9):1592-1598. doi: 10.1016/j.apmr.2019.03.014. Epub 2019 Apr 17.
Carpal tunnel syndrome (CTS) is frequently seen as a work-related disorder. Few studies have examined the treatment of CTS by insurance coverage, and none have used a large, population-based dataset. This study examined the extent to which the use of CTS tests and treatments varied for those on workers' compensation insurance (WCI) vs private insurance and Medicaid, controlling for patient and provider characteristics.
Analysis of 10 years of data (2005-2014) from the National Ambulatory Medical Care Survey.
United States office-based physician practices.
Adults 18-64 years who had a physician visit for CTS (N=23,236,449).
Not applicable.
We examined use of 2 diagnostic tests, imaging and electromyography, and 7 treatments: casting, splinting, occupational therapy (OT), physical therapy (PT), carpal tunnel release surgery, steroid injections, and nonsteroidal anti-inflammatory drug (NSAID).
Individuals who sought care for CTS were more likely to be covered by private insurance (56.9%) than WCI (9.8%) or Medicaid (6.5%). The most commonly prescribed treatment for all types of insurance coverage was splints, followed by NSAID prescription, and OT or PT therapies. Steroid injections (1.2%) and CTS surgery (4.5%) were used significantly less than other treatment types. Patients on WCI were less likely to receive diagnostic tests, and more likely to receive OT or PT than those on other types of insurance coverage.
Patients with CTS who seek ambulatory care are most likely to be covered by private insurance. Insurance coverage appears to play a role in treatment and diagnostic choices for CTS.
腕管综合征（CTS）常被视为与工作相关的疾病。很少有研究通过保险覆盖范围来研究 CTS 的治疗方法，也没有使用大型基于人群的数据集。本研究通过控制患者和提供者的特征，检查了在工人赔偿保险（WCI）与私人保险和医疗补助之间，使用 CTS 测试和治疗的程度有所不同。
对来自国家门诊医疗保健调查（2005-2014 年）的 10 年数据进行分析。
美国门诊医师实践。
患有 CTS 的 18-64 岁成年患者（N=23,236,449）。
不适用。
我们检查了两种诊断测试，影像学和肌电图，以及七种治疗方法的使用情况：石膏固定、夹板固定、职业治疗（OT）、物理治疗（PT）、腕管松解术、皮质类固醇注射和非甾体抗炎药（NSAID）。
寻求 CTS 治疗的患者更有可能通过私人保险（56.9%）而不是 WCI（9.8%）或医疗补助（6.5%）来支付费用。所有类型保险覆盖的最常见治疗方法是夹板，其次是 NSAID 处方和 OT 或 PT 治疗。皮质类固醇注射（1.2%）和 CTS 手术（4.5%）的使用明显低于其他治疗类型。WCI 患者接受诊断测试的可能性较小，而接受 OT 或 PT 的可能性较大，而不是其他类型的保险覆盖。
寻求门诊护理的 CTS 患者最有可能通过私人保险来支付费用。保险覆盖范围似乎在 CTS 的治疗和诊断选择中起着作用。
