Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans.

Autor:	Sanders HM; From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich., Tong Y; Department of Biostatistics, University of Michigan, Ann Arbor, Mich., Hooper RC; Division of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, Mich., Wang L; Department of Biostatistics, University of Michigan, Ann Arbor, Mich., Chung KC; Division of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, Mich.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 Mar 01; Vol. 12 (3), pp. e5659. Date of Electronic Publication: 2024 Mar 01 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000005659
Abstrakt:	Background: Delay in surgical treatment for carpal tunnel syndrome (CTS) may result in long-term decreased functional outcomes. Few investigators have examined the relationship between type of health insurance plan and time to definitive treatment of CTS following diagnosis. We investigated the relationship between insurance type, treatment decision, and the time between diagnosis and surgery across groups. Methods: This was a retrospective cohort study using the MarketScan Commercial Claims and Encounters Database 2011-2020. We used χ 2 tests, linear regression, and logistic regression models to analyze demographic data and the time lag interval between CTS diagnosis and treatment. Results: Overall, 28% of high-deductible health plan (HDHP) patients underwent carpal tunnel release, compared with 20% of traditional insurance patients ( P < 0.001). HDHPs are defined by the internal revenue service as a deductible of $1400 for an individual or $2800 for a family per year. The odds of undergoing surgery versus no treatment for HDHP patients were 47% higher than traditional patients ( P < 0.001). Among the patients who underwent surgery, HDHP patients underwent surgery 65 days earlier on average following diagnosis compared with traditional patients ( P < 0.001). Conclusions: Patients with HDHPs who receive a diagnosis of CTS are more likely to undergo surgery, with a shorter time lag between diagnosis and surgery. The results from this study call attention to differences in surgical decision-making between patients enrolled in different insurance plans. Competing Interests: Dr. Chung receives funding from the National Institutes of Health, book royalties from Wolters Kluwer and Elsevier, and a research grant from Sonex to study carpal tunnel outcomes. The other authors have no financial interest to declare in relation to the content of this article. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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