Quality of Care for Work-Associated Carpal Tunnel Syndrome

J Occup Environ Med. 2017 Jan;59(1):47-53. doi: 10.1097/JOM.0000000000000916.

Abstract

Objective: To evaluate the quality of care provided to individuals with workers' compensation claims related to Carpal tunnel syndrome (CTS) and identify patient characteristics associated with receiving better care.

Methods: We recruited subjects with new claims for CTS from 30 occupational clinics affiliated with Kaiser Permanente Northern California. We applied 45 process-oriented quality measures to 477 subjects' medical records, and performed multivariate logistic regression to identify patient characteristics associated with quality.

Results: Overall, 81.6% of care adhered to recommended standards. Certain tasks related to assessing and managing activity were underused. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.

Conclusions: Care processes for work-associated CTS frequently adhered to quality measures. Clinical factors were more strongly associated with quality than demographic and socioeconomic ones.

MeSH terms

  • Adult
  • California
  • Carpal Tunnel Syndrome / diagnosis
  • Carpal Tunnel Syndrome / therapy*
  • Electrodiagnosis
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Health Care Surveys
  • Humans
  • Income
  • Male
  • Medical History Taking / statistics & numerical data
  • Medical Overuse / statistics & numerical data
  • Medical Records
  • Middle Aged
  • Occupational Diseases / diagnosis
  • Occupational Diseases / therapy*
  • Outcome and Process Assessment, Health Care*
  • Practice Guidelines as Topic
  • Quality Indicators, Health Care*
  • Workers' Compensation