Variation in Nonsurgical Services for Carpal Tunnel Syndrome Across a Large Integrated Health Care System.

摘要: Purpose To evaluate facility-level variation in the use of services for patients with carpal tunnel syndrome (CTS) receiving care Veterans Health Administration (VHA). Methods A national cohort VHA diagnosed CTS during fiscal year 2013 was divided into nonsurgical and operative treatment groups comparison. We assessed 5 types CTS-related (electrodiagnostic studies [EDS], imaging, steroid injection, oral steroids, therapeutic modalities) prediagnosis postdiagnosis periods before any intervention at patient facility levels. Results Among 72,599 newly CTS, 5,666 (7.8%) received release within 12 months. The remaining 66,933 (92.2%) were group. Therapeutic modalities EDS most commonly employed after index diagnosis had large use. At level, ranged from 0% to 93% group (mean, 32%) compared 1% 67% 30%) period 100% 59%) 55% 26%) level. Conclusions There is wide among treatment. Care delivered by facilities highest lowest rates service may suggest overuse underuse, respectively, a lack consideration individual factors making health decisions regarding Clinical relevance Surgeons must understand degree variability comprehend ramifications reimbursement waste system, become involved devising strategies optimize hand across all phases care.