Factors Associated With the Cost of Care for the Most Common Atraumatic Painful Upper Extremity Conditions

Research output: Contribution to journalArticle

Abstract

Purpose: To help strategize efforts to optimize value (relative improvement in health for resources invested), we analyzed the factors associated with the cost of care and use of resources for painful, nontraumatic conditions of the upper extremity. Methods: The following were the most common upper extremity diagnoses in the Truven Health MarketScan database: shoulder pain and rotator cuff tendinopathy, shoulder stiffness, shoulder arthritis, lateral epicondylitis, hand arthritis, trigger finger, wrist pain, and hand pain. Multivariable generalized linear regression models were constructed accounting for sex, age, employment status, enrollment year, payer type, emergency room visit, joint injection, magnetic resonance imaging (MRI), physical or occupational therapy, outpatient and inpatient surgery, and insurance type. In addition, we assessed the use of the following 4 diagnostic and treatment interventions: joint injection, surgery, MRI, and physical or occupational therapy. Results: Inpatient and outpatient surgery are the largest contributors to the total amount paid for most diagnoses. Older patients had more injections for the majority of conditions. Conclusions: Efforts to improve the value of care for nontraumatic upper extremity pain can focus on the relative benefits of surgery compared with other treatments and interventions to lower the costs of surgery (eg, office surgery and limited draping for minor hand surgery). Type of study/level of evidence: Economic II.

Original languageEnglish (US)
Pages (from-to)989.e1-989.e18
JournalJournal of Hand Surgery
Volume44
Issue number11
DOIs
StatePublished - Nov 2019

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Ambulatory Surgical Procedures
Upper Extremity
Hand
Occupational Therapy
Costs and Cost Analysis
Pain
Injections
Arthritis
Inpatients
Linear Models
Joints
Tennis Elbow
Magnetic Resonance Imaging
Minor Surgical Procedures
Tendinopathy
Shoulder Pain
Rotator Cuff
Health Resources
Insurance
Wrist

Keywords

  • Commercial insurance
  • Medicare
  • cost
  • surgery
  • upper extremity

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Factors Associated With the Cost of Care for the Most Common Atraumatic Painful Upper Extremity Conditions. / Crijns, Tom J.; Ring, David; Valencia, Victoria.

In: Journal of Hand Surgery, Vol. 44, No. 11, 11.2019, p. 989.e1-989.e18.

Research output: Contribution to journalArticle

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