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Trends in Open and Endoscopic Cubital Tunnel Release in the Medicare Patient Population

机译：Medicare患者人群中开放和内窥镜下肘管释放的趋势

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Background: Cubital tunnel syndrome (CUT) is the second most common peripheral neuropathy with an annual incidence of 24.7 per 100?000, affecting nearly twice as many men as women. With increasing focus on cost-effectiveness and cost-containment in medicine, a critical understanding of utilization of health care resources for open and endoscopic approaches for cubital tunnel release is of value. The purpose of this study was to evaluate the costs and utilization trends of open and endoscopic cubital tunnel release. Methods: We performed a retrospective review of a Medicare database within the PearlDiver Supercomputer (Warsaw, Indiana) for procedures performed from 2005 to 2012. Annual utilization, charges, reimbursement, demographic data, and compound annual growth rate were evaluated. Results: Our query returned 262?104 patients with CUT, of which 69 378 (26.5%) and 4636 (1.8%) were surgically managed with open and endoscopic release respectively. Average charges were higher in endoscopic release ($3798) than open release ($3197) while reimbursements were higher in open releases ($1041) than endoscopic release, ($866). Both were performed most commonly in the &65 years age range. Conclusions: Despite the unexpectedly lower reimbursement rate with endoscopic release, endoscopy utilization is growing faster than open releases in the Medicare population. Lower reimbursement is likely related to lack of a dedicated current procedural terminology code for endoscopic cubital tunnel release.
机译：背景：肘管综合征（CUT）是第二常见的周围神经病，每年的发病率是每100000人中24.7人，影响的男性人数几乎是女性的两倍。随着人们越来越关注医学的成本效益和成本控制，对利用医疗资源进行肘管隧道开放和内窥镜检查方法的重要理解是有价值的。本研究的目的是评估开放式和内窥镜下肘管释放的成本和利用趋势。方法：我们对PearlDiver超级计算机（印第安纳州华沙）中的Medicare数据库进行了回顾性审查，以了解2005年至2012年执行的程序。评估了年度利用率，费用，报销，人口统计数据和复合年增长率。结果：我们的查询返回了262？104例CUT患者，其中69 378（26.5％）和4636（1.8％）分别接受了开放和内镜释放的手术治疗。内窥镜检查释放的平均费用（3798美元）高于开放检查释放的平均费用（3197美元），而开放检查的平均报销（1041美元）高于内窥镜检查的释放费用（866美元）。两者均最常在＜65岁的年龄范围内进行。结论：尽管内镜释放的报销率出乎意料的低，但在Medicare人群中，内窥镜利用的增长速度快于开放式释放。较低的报销可能与缺乏用于内窥镜下肘管释放的当前专用程序术语代码有关。

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