{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:42:25Z","timestamp":1747150945327,"version":"3.40.5"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS018982"],"award-info":[{"award-number":["R01HS018982"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004459","name":"RAND Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005977","name":"Kaiser Permanente","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005977","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/aims<\/jats:title><jats:p>In prior work, higher quality care for work\u2010associated carpal tunnel syndrome (CTS) was associated with improved symptoms, functional status, and overall health. We sought to examine whether quality of care is associated with healthcare expenditures or disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 343 adults with workers' compensation claims for CTS, we created patient\u2010level aggregate quality scores for underuse (not receiving highly beneficial care) and overuse (receiving care for which risks exceed benefits). We assessed whether each aggregate quality score (0%\u2013100%, 100%\u00a0=\u00a0better care) was associated with healthcare expenditures (18\u2010mo expenditures, any anticipated need for future expenditures) or disability (days on temporary disability, permanent impairment rating at 18\u2009mo).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean aggregate quality scores were 77.8% (standard deviation [SD] 16.5%) for underuse and 89.2% (SD 11.0%) for overuse. An underuse score of 100% was associated with higher risk\u2010adjusted 18\u2010mo expenditures ($3672; 95% confidence interval [CI] $324 to $7021) but not with future expenditures (\u22120.07 percentage points; 95% CI \u22120.48 to 0.34), relative to a score of 0%. An overuse score of 100% was associated with lower 18\u2010mo expenditures (\u2212$4549, 95% CI \u2212$8792 to \u2212$306) and a modestly lower likelihood of future expenditures (\u22120.62 percentage points, 95% CI \u22121.23 to \u22120.02). Quality of care was not associated with disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Improving quality of care could increase or lower short\u2010term healthcare expenditures, depending on how often care is currently underused or overused. Future research is needed on quality of care in varied workers' compensation contexts, as well as effective and economical strategies for improving quality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27718","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T13:08:18Z","timestamp":1663247298000},"page":"52-62","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The quality of occupational healthcare for carpal tunnel syndrome, healthcare expenditures, and disability outcomes: A prospective observational study"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0416-1595","authenticated-orcid":false,"given":"Teryl K.","family":"Nuckols","sequence":"first","affiliation":[{"name":"RAND Health Care RAND Corporation  Santa Monica California USA"},{"name":"Division of General Internal Medicine Department of Medicine, Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Dworsky","sequence":"additional","affiliation":[{"name":"RAND Health Care RAND Corporation  Santa Monica California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Conlon","sequence":"additional","affiliation":[{"name":"Employee Health The Permanente Medical Group  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Robbins","sequence":"additional","affiliation":[{"name":"RAND Health Care RAND Corporation  Santa Monica California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Benner","sequence":"additional","affiliation":[{"name":"EK Health Inc.  San Jose California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Seabury","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Health Economics, USC School of Pharmacy University of Southern California  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M.","family":"Asch","sequence":"additional","affiliation":[{"name":"RAND Health Care RAND Corporation  Santa Monica California USA"},{"name":"Division of Primary Care and Population Health, Department of Medicine Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.22048"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.22399"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000000916"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26858"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa022615"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.003617"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12402"},{"volume-title":"National Healthcare Quality and Disparities Report","year":"2019","author":"Agency for Healthcare Research and Quality","key":"e_1_2_10_9_1"},{"volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","year":"2001","author":"Institute of M","key":"e_1_2_10_10_1"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.07.002"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X04264212"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26041"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/15-220"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-6-200509200-00005"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21617"},{"volume-title":"RAND\/UCLA Quality\u2010of\u2010Care Measures for Carpal Tunnel Syndrome: Tools for Assessing Quality of Care and Appropriateness of Surgery","year":"2011","author":"Nuckols TK","key":"e_1_2_10_18_1"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-010-9260-6"},{"volume-title":"The RAND\/UCLA Appropriateness Method User's Manual","year":"2001","author":"Fitch K","key":"e_1_2_10_20_1"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181da8685"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26874"},{"key":"e_1_2_10_23_1","unstructured":"State of California Department of Industrial Relations Division of Worker's Compensation (DWC). 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