Objective: Carpal tunnel syndrome (CTS) is frequently seen as a work-related disorder. Few studies have examined the treatment of CTS by insurance coverage, and none have used a large, population-based dataset. This study examined the extent to which the use of CTS tests and treatments varied for those on workers' compensation insurance (WCI) vs private insurance and Medicaid, controlling for patient and provider characteristics.
Design: Analysis of 10 years of data (2005-2014) from the National Ambulatory Medical Care Survey.
Setting: United States office-based physician practices.
Participants: Adults 18-64 years who had a physician visit for CTS (N=23,236,449).
Interventions: Not applicable.
Main Outcome Measures: We examined use of 2 diagnostic tests, imaging and electromyography, and 7 treatments: casting, splinting, occupational therapy (OT), physical therapy (PT), carpal tunnel release surgery, steroid injections, and nonsteroidal anti-inflammatory drug (NSAID).
Results: Individuals who sought care for CTS were more likely to be covered by private insurance (56.9%) than WCI (9.8%) or Medicaid (6.5%). The most commonly prescribed treatment for all types of insurance coverage was splints, followed by NSAID prescription, and OT or PT therapies. Steroid injections (1.2%) and CTS surgery (4.5%) were used significantly less than other treatment types. Patients on WCI were less likely to receive diagnostic tests, and more likely to receive OT or PT than those on other types of insurance coverage.
Conclusion: Patients with CTS who seek ambulatory care are most likely to be covered by private insurance. Insurance coverage appears to play a role in treatment and diagnostic choices for CTS.
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http://dx.doi.org/10.1016/j.apmr.2019.03.014 | DOI Listing |
J Geriatr Emerg Med
December 2024
Geriatric Research Education and Clinic Center, James J. Peters VA Medical Center, 130 W Kingsbridge Rd, Bronx, NY 10468 & Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029.
Background: Older adults treated in emergency departments (EDs) are at higher risk for adverse outcomes. Using multiple facilities can worsen this issue through service duplication and poor care transitions. Veterans with dual insurance coverage can access both Veterans Health Administration (VHA) and non-VHA EDs.
View Article and Find Full Text PDFJCEM Case Rep
February 2025
Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA.
A 65-year-old patient presented with recurrent, locally advanced poorly differentiated thyroid cancer despite 2 neck surgeries, and with newly diagnosed brain and skull base metastases. He was treated with palliative stereotactic radiosurgery to the brain and skull base lesions. Thereafter, as no targetable genetic alteration was identified and antiangiogenic multikinase inhibitors were deemed at high risk of hemorrhagic complications, off-label systemic therapies were considered.
View Article and Find Full Text PDFPurpose: Despite expanding health insurance coverage under the Patient Protection and Affordable Care Act (ACA), many Americans struggle with financial barriers to health care. Medicaid expansion was meant to help alleviate these barriers, particularly for rural communities, but has shown mixed results. The American Indian and Alaska Native (AI/AN) community, which faces both racial and geographic disparities, is a group that should benefit from Medicaid expansion.
View Article and Find Full Text PDFJMIR Form Res
January 2025
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States.
Background: Low rates of adolescent and young adult (YA; aged 15-39 y) clinical trial enrollment (CTE), particularly among underserved groups, have resulted in a lack of standardized cancer treatments and follow-up guidelines for this group that may limit improvement in cancer treatments and survival outcomes for YAs.
Objective: To understand and address unique barriers to CTE, we conducted focus groups to learn about informational, financial, and psychosocial needs of YAs surrounding CTE and identify strategies to address these barriers.
Methods: We conducted 5 focus groups in 2023 among a diverse sample of YA patients from across the United States.
J Clin Med
January 2025
Young Leaders Advocacy Group, Diabetes Research Institute Foundation, Hollywood, FL 33021, USA.
Type 1 Diabetes (T1D) is a progressive autoimmune disease often identified in childhood or adolescence, with early stages detectable through pre-diabetic markers such as autoantibodies and subclinical beta-cell dysfunction. The identification of the pre-T1D stage is critical for preventing complications, such as diabetic ketoacidosis, and for enabling timely interventions that may alter disease progression. This review examines the multifaceted approach to managing T1D risk in adolescents and teens, emphasizing early detection, nutritional interventions, beta-cell preservation strategies, and psychosocial support.
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