Quality of Care for Work-Associated Carpal Tunnel Syndrome.

Nuckols, Teryl; Conlon, Craig; Robbins, Michael; Dworsky, Michael; Lai, Julie; Roth, Carol P; Levitan, Barbara; Seabury, Seth et al. · J Occup Environ Med · 2017

retrospective_cohort · Level III

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Abstract

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

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