The Influence of Insurance Type on Management of Carpal Tunnel Syndrome: An Analysis of Nationwide Practice Trends.

Abstract:

BACKGROUND:The purpose of this study was to evaluate the impact of insurance type on use of diagnostic testing, treatments, and the efficiency of care for patients with carpal tunnel syndrome. METHODS:The 2009 to 2013 Truven MarketScan Databases were used to identify adult patients with carpal tunnel syndrome. Insurance type was categorized as fee-for-service versus capitated managed care. Multivariable regression models were created to evaluate the relationship between insurance type and costs, number of visits, treatment, and electrodiagnostic study use, and controlling for demographic characteristics and comorbidities. RESULTS:The cohort included 233,572 patients, of which 86 percent carried fee-for-service insurance. Predicted probabilities were clinically similar between the capitated and fee-for-service insurance types for therapy (0.23 versus 0.24), steroid injection (0.07 versus 0.09), and electrodiagnostic study use (0.44 versus 0.47). The difference in predicted probabilities between the insurance groups was greatest for surgery use (0.22 versus 0.28 for managed care and fee-for-service, respectively). The mean number of visits was similar between the two groups (2.1 versus 2.0 visits). In the controlled analysis, managed care was associated with a 10 percent decrease in cost compared to patients with fee-for-service (p < 0.001). CONCLUSIONS:Managed care was associated with a lower probability of surgery than fee-for-service, but similar use of less costly services. These data may be used to predict future practice trends with increased implementation of bundled payment reimbursement. Routine collection of validated patient outcomes measures is critical to assess patient outcomes associated with anticipated reduction of surgical services. CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, II.

journal_name

Plast Reconstr Surg

authors

Sears ED,Swiatek PR,Hou H,Chung KC

doi

10.1097/PRS.0000000000002635

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

1041-1049

issue

5

eissn

0032-1052

issn

1529-4242

pii

00006534-201611000-00023

journal_volume

138

pub_type

杂志文章
  • Rheumatoid arthritis and Dupuytren's contracture.

    abstract::Of four patients with rheumatoid arthritis and Dupuytren's contracture, two were not aware of the presence of Dupuytren's contracture. When both diseases coexist, the presence of rheumatoid hand deformities, especially flexion and ulnar deviation of the metacarpophalangeal joints, may mask the flexion deformity caused...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198801000-00010

    authors: Rayan GM

    更新日期:1988-01-01 00:00:00

  • The Stacked Hemiabdominal Extended Perforator Flap for Autologous Breast Reconstruction.

    abstract:BACKGROUND:Options for bilateral autologous breast reconstruction in thin women are limited. The aim of this study was to introduce a novel approach to increase abdominal flap volume with the stacked hemiabdominal extended perforator (SHAEP) flap. The authors describe the surgical technique and analyze their results. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005058

    authors: Beugels J,Vasile JV,Tuinder SMH,Delatte SJ,St-Hilaire H,Allen RJ,Levine JL

    更新日期:2018-12-01 00:00:00

  • The extensor digitorum brevis muscle island flap for soft-tissue loss around the ankle.

    abstract::The extensor digitorum brevis muscle flap, which has already been suggested as a local flap for the foot, has been applied by us in 2 cases with excellent results. This flap, as with other muscle flaps, provides an excellent bed for the skin graft. Furthermore, because of its width, it allows for covering an area of s...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198506000-00024

    authors: Landi A,Soragni O,Monteleone M

    更新日期:1985-06-01 00:00:00

  • Can You Trust What You Watch? An Assessment of the Quality of Information in Aesthetic Surgery Videos on YouTube.

    abstract:BACKGROUND:Videos on YouTube can be posted without regulation or content oversight. Unfortunately, many patients use YouTube as a resource on aesthetic surgery, leading to misinformation. Currently, there are no objective assessments of the quality of information on YouTube about aesthetic surgery. METHODS:YouTube was...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006463

    authors: Gray MC,Gemmiti A,Ata A,Jun B,Johnson PK,Ricci JA,Patel A

    更新日期:2020-02-01 00:00:00

  • Untreated hemangiomas: growth pattern and residual lesions.

    abstract:BACKGROUND:Hemangiomas of infancy can give rise to alarm because of their rapid growth and occasional dramatic appearance. The objective of this study was to investigate the growth pattern of hemangiomas and risk factors for residual lesions. METHODS:A follow-up study was performed of patients with hemangiomas that we...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318208d2ac

    authors: Bauland CG,Lüning TH,Smit JM,Zeebregts CJ,Spauwen PHM

    更新日期:2011-04-01 00:00:00

  • Does the gatekeeper model work in hand surgery?

    abstract:BACKGROUND:Most managed care plans use a physician "gatekeeper" to control referrals to hand surgeons. The appropriateness of this model for upper extremity complaints has never been challenged. The purpose of this study was to evaluate the prior management of patients with elective hand disorders who present to a hand...

    journal_title:Plastic and reconstructive surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/PRS.0b013e31829acc74

    authors: Hartzell TL,Shahbazian JH,Pandey A,Girson LA,Rubinstein R,Bojovic B,Bernthal N,Azari KK,Benhaim P

    更新日期:2013-09-01 00:00:00

  • The Importance of Reproducibility in Plastic Surgery Research.

    abstract::With the advent of big data and database-driven research, the need for reproducible methods has become especially relevant. Given the rise of evidence-based practice, it is crucial to ensure that findings making use of big data can be consistently replicated by other physician-scientists. A call for transparency and r...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005784

    authors: Ascha M,Ascha MS,Gatherwright J

    更新日期:2019-07-01 00:00:00

  • Single-stage management of 74 consecutive sternal wound complications with pectoralis major myocutaneous advancement flaps.

    abstract::The optimal management of sternal wound complications remains controversial. Since 1985, we have utilized a combination of immediate, aggressive debridement with simultaneous repair using bilateral pectoralis major myocutaneous advancement flaps, regardless of the degree of infection. As compared with the use of dista...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199406000-00016

    authors: Hugo NE,Sultan MR,Ascherman JA,Patsis MC,Smith CR,Rose EA

    更新日期:1994-06-01 00:00:00

  • Avulsion Thighplasty: Technique Overview and 6-Year Experience.

    abstract:UNLABELLED:When choosing a thigh lift operation, the surgeon also chooses which complications he/she will be managing, and the most dreaded after conventional thigh lifting are those of lymphatic origin such as lymphocele or lymphedema. The authors describe avulsion thighplasty, a technique that spares lymphatics by us...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000001936

    authors: Hunstad JP,Kortesis BG,Knotts CD

    更新日期:2016-01-01 00:00:00

  • Magnetic resonance imaging and explantation investigation of long-term silicone gel implant integrity.

    abstract:BACKGROUND:Information about silicone gel implant longevity is sparse. Magnetic resonance imaging studies have superseded explantation studies in the search for data on their long-term integrity. Unfortunately, the majority of studies are based predominantly on second-generation implant cohorts. Although magnetic reson...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000279374.99503.89

    authors: Collis N,Litherland J,Enion D,Sharpe DT

    更新日期:2007-10-01 00:00:00

  • The national utilization of immediate and early delayed breast reconstruction and the effect of sociodemographic factors.

    abstract::The purpose of this study was to identify important sociodemographic factors affecting the utilization of immediate and early delayed postmastectomy breast reconstruction in the United States. Using the Surveillance, Epidemiology, and End Results (SEER) program, all cases of mastectomy-treated breast cancer that were ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.PRS.0000041438.50018.02

    authors: Alderman AK,McMahon L Jr,Wilkins EG

    更新日期:2003-02-01 00:00:00

  • Use of the pharyngeal flap in the treatment of congenital velopharyngeal incompetence.

    abstract::Seventy-four patients were referred to the senior author because of presumed velopharyngeal incompetence without cleft palate. As a result of an extensive preoperative evaluation that included assessment of articulation patterns, nasal emission, oronasal resonance, and general speech intelligibility, 57 of the 74 pati...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198402000-00010

    authors: Stueber K,Wilhelmsen HR

    更新日期:1984-02-01 00:00:00

  • Modification of the Dott-Dingman mouth gag.

    abstract::In cleft palate patients with a protrucing premaxilla, retrusion or collapse, the abnormal alveolar arches require a mouth gag which can be fitted to the individual. This modification of the Dott-Dingman mouth gag allows maximum adjustability and exposure. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Millard DR Jr,Slepyan DH

    更新日期:1977-04-01 00:00:00

  • The evolution of techniques for reconstruction of full-thickness cheek defects.

    abstract::Our experience with 20 full-thickness cheek reconstruction in 17 patients over the past 27 years is presented. The evolution of techniques for management of full-thickness cheek defects reflects our gradual appreciation of the longitudinal artery concept within axial and musculocutaneous flap units. During the 1950s, ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198209000-00004

    authors: Bunkis J,Mulliken JB,Upton J,Murray JE

    更新日期:1982-09-01 00:00:00

  • Autologous Ear Reconstruction for Microtia Does Not Result in Loss of Cutaneous Sensitivity.

    abstract:BACKGROUND:Cutaneous sensitivity of microtia reconstruction has been sparsely documented. The purpose of this study was to evaluate whether there is a loss of cutaneous sensitivity following two-stage autologous ear reconstruction for unilateral microtia. METHODS:A prospective study was performed including unilateral ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005485

    authors: Denadai R,Raposo-Amaral CE,Zanco GL,Raposo-Amaral CA

    更新日期:2019-04-01 00:00:00

  • Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair.

    abstract::The purpose of this study was to determine the incidence of cleft palatal fistula in a series of nonsyndromic children treated at the authors' institution. This retrospective analysis of 103 patients with cleft palate treated by five surgeons between 1982 and 1995 includes 60 boys and 33 girls, whose median age was 18...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200111000-00011

    authors: Muzaffar AR,Byrd HS,Rohrich RJ,Johns DF,LeBlanc D,Beran SJ,Anderson C,Papaioannou aA A

    更新日期:2001-11-01 00:00:00

  • Quantitative analysis of blood and fat in suction lipectomy aspirates.

    abstract::This study of suction lipectomy aspirates from 15 consecutive patients was undertaken to biochemically quantitate the blood-to-fat ratios of the aspirates. A wide variation in the blood-to-fat ratios (8 to 54 percent) was noted, but the authors failed to demonstrate any relationship between the blood-to-fat ratios and...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198678060-00009

    authors: Goodpasture JC,Bunkis J

    更新日期:1986-12-01 00:00:00

  • The biophysics of mandibular fractures: an evolution toward understanding.

    abstract:BACKGROUND:Predicting outcomes based on a variety of fixation techniques remains problematic in the treatment of mandible fractures. There is inherent difficulty in comparing the hundreds of published articles on the subject because of the large number of variables, including injury patterns, assessment techniques, tre...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/01.prs.0000297646.86919.b7

    authors: Rudderman RH,Mullen RL,Phillips JH

    更新日期:2008-02-01 00:00:00

  • Care of maxillofacial injuries: survey of plastic surgeons.

    abstract::The purpose of this survey was to evaluate the current trends in the care of facial trauma. Data were obtained through the responses of a survey mailed to all those members and candidates listed in the 1989 American Society of Plastic and Reconstructive Surgeons Directory. A total of 2777 questionnaires were sent, wit...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199210000-00003

    authors: Thaller SR,Kawamoto HK

    更新日期:1992-10-01 00:00:00

  • Anaphylactic-like reaction to methylene blue: case report and review of perioperative hypersensitivity reactions.

    abstract:BACKGROUND:Anaphylaxis and anaphylactic-like reactions in the perioperative period are a significant concern for anesthesiologists and surgeons. With an incidence as high as one in 3500 and a mortality rate of 3 to 6 percent, proper management of these reactions is essential. The available surgical literature provides ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318254b2b8

    authors: Giladi AM,Kasten SJ

    更新日期:2012-07-01 00:00:00

  • The role of acellular dermal matrices in capsular contracture: a review of the evidence.

    abstract::Despite advances in breast implant surgery, capsular contracture remains a challenging sequela of reconstructive and cosmetic breast implant surgery. Although there are established modalities for treatment, most recently, acellular dermal matrix products have been suggested to have a role in preventing or diminishing ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0b013e318262df58

    authors: Basu CB,Jeffers L

    更新日期:2012-11-01 00:00:00

  • The angiogenic and adipogenic modes of adipose tissue after free fat grafting.

    abstract:BACKGROUND:The major drawback of adipose grafting is its clinical unpredictability, which leads to surgeon and patient dissatisfaction. The mechanisms underlying angiogenesis and regeneration of the graft tissue are still unclear. METHODS:Mouse adipose tissue was processed using two different methods (fragmental and i...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000965

    authors: Dong Z,Peng Z,Chang Q,Zhan W,Zeng Z,Zhang S,Lu F

    更新日期:2015-03-01 00:00:00

  • Obtaining a gentle contour to the columella by modifying the maxillary spine.

    abstract::There are several structures involved in columellaplasty, and all affect the support and shape of the tip, the columella, and the upper lip. The present paper considers only the problem of the deformities of the maxillary spine and its lower extension over the midline, causing broadening and asymmetrical development o...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198111000-00003

    authors: Stoksted P,Gutierrez C

    更新日期:1981-11-01 00:00:00

  • Postoperative medical complications--not microsurgical complications--negatively influence the morbidity, mortality, and true costs after microsurgical reconstruction for head and neck cancer.

    abstract:BACKGROUND:Immediate reconstruction of composite head and neck defects using free tissue transfer is an accepted treatment standard. There remains, however, ongoing debate on whether the costs associated with this reconstructive approach merit its selection, especially considering poor patient prognoses and the high co...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000260591.82762.b5

    authors: Jones NF,Jarrahy R,Song JI,Kaufman MR,Markowitz B

    更新日期:2007-06-01 00:00:00

  • J. G. Hierzel: a lip-switch flap in 1756.

    abstract::After reviewing the historical aspects of the various lip-switch flaps, the authors draw attention to the existence of a report of a lip-switch flap performed in Sweden in 1756 by J.G.Hierzel. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 传,历史文章,杂志文章

    doi:

    authors: Vrebos J,Dupuis C

    更新日期:1994-01-01 00:00:00

  • Comparison of Outcomes following Autologous Breast Reconstruction Using the DIEP and Pedicled TRAM Flaps: A 12-Year Clinical Retrospective Study and Literature Review.

    abstract:BACKGROUND:There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery r...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000001747

    authors: Knox ADC,Ho AL,Leung L,Tashakkor AY,Lennox PA,Van Laeken N,Macadam SA

    更新日期:2016-07-01 00:00:00

  • Enhanced Recovery after Surgery Protocols Decrease Outpatient Opioid Use in Patients Undergoing Abdominally Based Microsurgical Breast Reconstruction.

    abstract:BACKGROUND:Enhanced recovery after surgery (ERAS) protocols have known benefits in the inpatient setting, but little is known about their impact in the subsequent outpatient setting. On discharge, multimodal analgesia has been discontinued, nerve blocks and pain pumps have worn off, and patients enter a substantially d...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006546

    authors: Rendon JL,Hodson T,Skoracki RJ,Humeidan M,Chao AH

    更新日期:2020-03-01 00:00:00

  • Cost-Effectiveness of Treatments after Closed Extraarticular Distal Radius Fractures in Older Adults from the WRIST Clinical Trial.

    abstract:BACKGROUND:This study performs an economic analysis of volar locking plate, external fixation, percutaneous pinning, or casting in elderly patients with closed distal radius fractures. METHODS:This is a secondary analysis of the Wrist and Radius Injury Surgical Trial, a randomized, multicenter, international clinical ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000007528

    authors: Yoon AP,Shauver MJ,Hutton DW,Chung KC,WRIST Group.

    更新日期:2021-02-01 00:00:00

  • Follicular anatomy of the anterior temporal hairline and implications for rhytidectomy.

    abstract:BACKGROUND:Incisions made perpendicular to the hair follicles during anterior frontal hairline brow lifts or forehead shortening procedures help produce an inconspicuous forehead scar. The success of this "hidden" incision relies on the anteriorly directed frontal hairline follicles and their growth vector. The authors...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000259191.59277.7a

    authors: Mowlavi A,Majzoub RK,Cooney DS,Wilhelmi BJ,Guyuron B

    更新日期:2007-05-01 00:00:00

  • Not All Gustilo Type IIIB Fractures Are Created Equal: Arterial Injury Impacts Limb Salvage Outcomes.

    abstract:BACKGROUND:Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical out...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003766

    authors: Stranix JT,Lee ZH,Jacoby A,Anzai L,Avraham T,Thanik VD,Saadeh PB,Levine JP

    更新日期:2017-11-01 00:00:00