Gill Vikram S, Holle Alejandro M, Lin Eugenia, Tummala Sailesh V, Haglin Jack M, Renfree Kevin J
Orthopedics. 2025 Jan-Feb;48(1):e45-e51. doi: 10.3928/01477447-20241127-02. Epub 2024 Dec 3.
The purpose of this study was to evaluate changes in open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR) utilization, reimbursement, and patient demographics in the Medicare population from 2013 to 2021 at national and regional levels.
The Medicare Physician & Other Practitioners database from 2013 to 2021 was queried to extract all instances of OCTR and ECTR. Utilization per 10,000 beneficiaries, inflation-adjusted reimbursement, and patient characteristics were extracted for OCTR and ECTR each year. Data were stratified by region based on US Census guidelines. Kruskal-Wallis tests and multivariable linear regressions were performed.
From 2013 to 2021, national utilization per 10,000 beneficiaries increased by 6% for OCTR and by 50% for ECTR. In 2021, the Midwest had the greatest utilization of OCTR (29 of 10,000) and the lowest utilization of ECTR (7 of 10,000). Inflation-adjusted reimbursement declined for both OCTR and ECTR during the study period (10.3% and 11.8%, respectively), with the South having the lowest reimbursement for both procedures. The severity of patient comorbidity profiles and dual Medicare-Medicaid enrollees decreased for both procedures as well.
Both OCTR and ECTR utilization have increased, while inflation-adjusted reimbursement has decreased. Patient populations encompassed fewer dual Medicare-Medicaid enrollees, indicating surgeons may be more selective in operative indications. These findings should be addressed to ensure the economic sustainability of carpal tunnel release procedures and equitable access to quality hand care for all patients with Medicare. [. 2025;48(1):e45-e51.].
本研究的目的是评估2013年至2021年医疗保险人群中开放性腕管松解术（OCTR）和内镜下腕管松解术（ECTR）在全国和地区层面的使用情况、报销情况及患者人口统计学特征的变化。
查询2013年至2021年医疗保险医师及其他从业者数据库，提取所有OCTR和ECTR病例。每年提取OCTR和ECTR每10,000名受益人的使用情况、经通胀调整的报销情况及患者特征。数据根据美国人口普查指南按地区分层。进行了Kruskal-Wallis检验和多变量线性回归分析。
2013年至2021年，OCTR每10,000名受益人的全国使用量增加了6%，ECTR增加了50%。2021年，中西部地区OCTR的使用量最高（每10,000人中有29例），ECTR的使用量最低（每10,000人中有7例）。在研究期间，OCTR和ECTR经通胀调整的报销金额均有所下降（分别下降了10.3%和11.8%），两个手术在南方的报销金额最低。两种手术患者合并症的严重程度以及同时参加医疗保险和医疗补助的参保人数也有所下降。
OCTR和ECTR的使用量均有所增加，而经通胀调整的报销金额有所下降。患者群体中同时参加医疗保险和医疗补助的参保人数减少，这表明外科医生在手术适应症方面可能更加谨慎。应关注这些发现，以确保腕管松解术的经济可持续性，并为所有医疗保险患者公平提供优质手部护理。[. 2025;48(1):e45-e51.]
