title: Quality of Care for Work-Associated Carpal Tunnel Syndrome.
abstract: To evaluate the quality of care provided to individuals with workers' compensation claims related to Carpal tunnel syndrome (CTS) and identify patient characteristics associated with receiving better care.
  
  
  
  We recruited subjects with new claims for CTS from 30 occupational clinics affiliated with Kaiser Permanente Northern California. We applied 45 process-oriented quality measures to 477 subjects' medical records, and performed multivariate logistic regression to identify patient characteristics associated with quality.
  
  
  
  Overall, 81.6% of care adhered to recommended standards. Certain tasks related to assessing and managing activity were underused. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
  
  
  
  Care processes for work-associated CTS frequently adhered to quality measures. Clinical factors were more strongly associated with quality than demographic and socioeconomic ones.
authors.affiliation: RAND Corporation, Santa Monica (Dr Nuckols, Dr Robbins, Dr Dworsky, Ms Lai, Ms Roth, Ms Levitan, Ms Seelam, Dr Asch); Division of General Internal Medicine, Cedars-Sinai Medical Center (Dr Nuckols); Employee Health, The Permanente Medical Group, Oakland (Dr Conlon); University of Southern California, USC Schaeffer Center (Dr Seabury), Los Angeles; VA Palo Alto Health Care System, Menlo Park (Dr Asch); and Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, Palo Alto (Dr Asch), California.
authors.forename: Teryl
authors.initials: T
authors.lastname: Nuckols
authors.forename: Craig
authors.initials: C
authors.lastname: Conlon
authors.forename: Michael
authors.initials: M
authors.lastname: Robbins
authors.forename: Michael
authors.initials: M
authors.lastname: Dworsky
authors.forename: Julie
authors.initials: J
authors.lastname: Lai
authors.forename: Carol P
authors.initials: CP
authors.lastname: Roth
authors.forename: Barbara
authors.initials: B
authors.lastname: Levitan
authors.forename: Seth
authors.initials: S
authors.lastname: Seabury
authors.forename: Rachana
authors.initials: R
authors.lastname: Seelam
authors.forename: Steven M
authors.initials: SM
authors.lastname: Asch
mesh_terms: D000328:Adult; D002140:California; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000628:therapy*; D004568:Electrodiagnosis; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007182:Income; D008297:Male; D008487:Medical History Taking / Q000706:statistics & numerical data; D000069342:Medical Overuse / Q000706:statistics & numerical data; D008499:Medical Records; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D014942:Workers' Compensation