Henry Tyler W, Townsend Clay B, Beredjiklian Pedro K
Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
Division of Hand Surgery, Rothman Orthopaedic Institute, Philadelphia, USA.
Cureus. 2021 Apr 22;13(4):e14629. doi: 10.7759/cureus.14629.
Background The impact of Workers' Compensation (WC) status on postoperative healthcare utilization in hand and wrist surgery clinical practice is presently unclear. The purpose of this study was to compare the number of postoperative visits in WC to non-WC patients after common upper extremity surgical procedures. Methodology All patients who underwent one of four common surgical procedures (carpal tunnel release, De Quervain's release, cubital tunnel release, and trigger finger release) between 2016 and 2019 were identified. A total of 64 surgeries billed under WC were randomly selected and matched 1:1 to surgeries billed outside of WC based on the primary CPT code. Results The most common procedure was carpal tunnel release (42 patients), followed by trigger finger release (30 patients), cubital tunnel release (28 patients), and De Quervain's release (16 patients). The average number of postoperative visits was 2.3 (median = 2, range: 1-9) and was significantly higher in the WC group (mean/median = 3.0/3 versus 1.5/1, p < 0.001). Within the 90-day global postoperative billing period, the mean number of visits was 2.2 (median = 2, range: 1-4) in the WC group and 1.4 (median = 1, range: 1-3) in the non-WC group (p < 0.001). The average time to clinical discharge in the WC group was 101 days (range: 10-446 days), and in the non-WC group was 40 days (range: 7-474 days) (p < 0.001). Five patients (7.8%) in the WC group and four patients (6.3%) in the non-WC group were seen for unplanned visits after clinical discharge. Conclusions WC status conferred more postoperative visits after common upper extremity surgical procedures, both within and beyond the global billing period. Further investigation and targeted strategies are required to address the observed increase in healthcare utilization.
背景 目前尚不清楚工伤赔偿(WC)状态对手腕和手部手术临床实践中术后医疗保健利用情况的影响。本研究的目的是比较上肢常见手术后,工伤赔偿患者与非工伤赔偿患者的术后就诊次数。方法 确定了2016年至2019年间接受四种常见手术(腕管松解术、桡骨茎突狭窄性腱鞘炎松解术、肘管松解术和扳机指松解术)之一的所有患者。根据主要CPT代码,随机选择了64例工伤赔偿账单下的手术,并与工伤赔偿范围外的手术按1:1进行匹配。结果 最常见的手术是腕管松解术(42例患者),其次是扳机指松解术(30例患者)、肘管松解术(28例患者)和桡骨茎突狭窄性腱鞘炎松解术(16例患者)。术后就诊的平均次数为2.3次(中位数 = 2,范围:1 - 9),工伤赔偿组显著更高(平均值/中位数 = 3.0/3对1.5/1,p < 0.001)。在90天的术后全球计费期内,工伤赔偿组的平均就诊次数为2.2次(中位数 = 2,范围:1 - 4),非工伤赔偿组为1.4次(中位数 = 1,范围:1 - 3)(p < 0.001)。工伤赔偿组的平均临床出院时间为101天(范围:10 - 446天),非工伤赔偿组为40天(范围:7 - 474天)(p < 0.001)。工伤赔偿组有5例患者(7.8%)和非工伤赔偿组有4例患者(6.3%)在临床出院后进行了非计划就诊。结论 工伤赔偿状态在上肢常见手术后,无论在全球计费期内还是之外,都会导致更多的术后就诊。需要进一步调查并制定针对性策略,以应对观察到的医疗保健利用增加的情况。