{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:06:59Z","timestamp":1777662419451,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T00:00:00Z","timestamp":1536278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>Background: Workers\u2019 compensation is intended for injuries that occur at work and is expected to be mostly for trauma and mostly nondiscretionary conditions. We tested the null hypothesis that there is no difference in the ratio of likely discretionary to likely nondiscretionary surgery between patients treated under workers\u2019 compensation compared with commercial insurance controlling for age, sex, and anatomical site for either traumatic or nontraumatic diagnoses. Methods: Using claims data from the Texas workers\u2019 compensation database and Truven Health commercial claims we classified International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses and procedure codes as likely discretionary or likely nondiscretionary, and as traumatic or nontraumatic. Ratios of likely discretionary to likely nondiscretionary surgery were calculated and compared. Results: Among patients treated under workers\u2019 compensation, the ratio of likely discretionary to likely nondiscretionary surgery was significantly higher for traumatic diagnoses (0.57 [95% confidence interval, CI, = 0.56-0.61] vs 0.38 [95% CI = 0.37-0.40], P &lt; .05) and significantly lower for nontraumatic diagnoses (9.4 [95% CI = 9.20-9.42] vs 13.2 [95% CI = 12.9-13.3], P &lt; .05) compared with commercial insurance. Conclusions: Workers\u2019 compensation often covers likely discretionary musculoskeletal surgery, and insurance type may influence treatment.<\/jats:p>","DOI":"10.1177\/1558944718799392","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T14:09:49Z","timestamp":1536329389000},"page":"95-101","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Discretionary Surgery: A Comparison of Workers\u2019 Compensation and Commercial Insurance"],"prefix":"10.1177","volume":"14","author":[{"given":"Bonheur A. T. D.","family":"van der Gronde","sequence":"first","affiliation":[{"name":"Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom J.","family":"Crijns","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2910-5071","authenticated-orcid":false,"given":"David","family":"Ring","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,9,7]]},"reference":[{"key":"bibr1-1558944718799392","unstructured":"Insureon. A Brief (Non-Boring) History of Workers\u2019 Compensation. https:\/\/www.insureon.com\/blog\/post\/2014\/05\/06\/history-of-workers-comp.aspx. Published 2014. Accessed July 27, 2018."},{"key":"bibr2-1558944718799392","unstructured":"Lucire Y. Constructing RSI: Belief and Desire. University of New South Wales Limited. https:\/\/books.google.nl\/books?id=R6AKAAAACAAJ. Published 2003. Accessed August 23, 2018."},{"key":"bibr3-1558944718799392","volume-title":"Whiplash and Other Useful Illnesses","author":"Malleson A.","year":"2005"},{"key":"bibr4-1558944718799392","unstructured":"Shorter E. From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era. Free Press; 1992."},{"key":"bibr5-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1023\/B:JOOR.0000047429.73907.fa"},{"key":"bibr6-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2014.08.001"},{"key":"bibr7-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1177\/1558944717732064"},{"key":"bibr8-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2017.07.021"},{"key":"bibr9-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-017-5401-y"},{"key":"bibr10-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/27.1.91"},{"key":"bibr11-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1177\/1553350615573579"},{"key":"bibr12-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2436-y"},{"key":"bibr13-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4993-y"},{"key":"bibr14-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.10.009"},{"key":"bibr15-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.06.122"},{"key":"bibr16-1558944718799392","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2015.05.042"},{"key":"bibr17-1558944718799392","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200709000-00006"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944718799392","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1558944718799392","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944718799392","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:29:10Z","timestamp":1777447750000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1558944718799392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,7]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1177\/1558944718799392"],"URL":"https:\/\/doi.org\/10.1177\/1558944718799392","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,7]]}}}