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

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 rel...

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Main Authors: Hayley M. Sanders, BS, Yanlin Tong, BS, Rachel C. Hooper, MD, Lu Wang, PhD, Kevin C. Chung, MD, MS
Format: Article
Language:English
Published: Wolters Kluwer 2024-03-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005659
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author Hayley M. Sanders, BS
Yanlin Tong, BS
Rachel C. Hooper, MD
Lu Wang, PhD
Kevin C. Chung, MD, MS
author_facet Hayley M. Sanders, BS
Yanlin Tong, BS
Rachel C. Hooper, MD
Lu Wang, PhD
Kevin C. Chung, MD, MS
author_sort Hayley M. Sanders, BS
collection DOAJ
description 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 χ2 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.
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spelling doaj.art-95ddff88f10a470d85f97eeb4257c4e42024-03-27T03:41:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-03-01123e565910.1097/GOX.0000000000005659202403000-00007Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health PlansHayley M. Sanders, BS0Yanlin Tong, BS1Rachel C. Hooper, MD2Lu Wang, PhD3Kevin C. Chung, MD, MS4From the * Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich.† Department of Biostatistics, University of Michigan, Ann Arbor, Mich.‡ Division of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, Mich.† Department of Biostatistics, University of Michigan, Ann Arbor, Mich.‡ Division of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, Mich.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 χ2 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.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005659
spellingShingle Hayley M. Sanders, BS
Yanlin Tong, BS
Rachel C. Hooper, MD
Lu Wang, PhD
Kevin C. Chung, MD, MS
Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans
Plastic and Reconstructive Surgery, Global Open
title Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans
title_full Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans
title_fullStr Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans
title_full_unstemmed Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans
title_short Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans
title_sort decision for carpal tunnel surgery high deductible health plans versus traditional health plans
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005659
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