Purpose
Our primary purpose was to quantify the proportion of minor hand surgeries performed
in the procedure room (PR) setting in a population-based cohort. Given the increase
in the literature that has emerged since the mid-2000s highlighting the benefits of
the PR setting, we hypothesized that a trend analysis would reveal increased utilization
over time.
Methods
We used the 2006–2017 MarketScan Commercial Database to identify adults who underwent
isolated minor hand surgeries performed in PR and operation room surgical settings
in the United States. The Cochran-Armitage trends test was used to determine whether
the proportion of all procedures (PR + operation room) changed over time.
Results
A total of 257,581 surgeries were included in the analysis, of which 24,966 (11.5%)
were performed in the PR. There was an increase in the overall number of surgeries
under study as well as increased utilization of the PR setting for open carpal tunnel
release, trigger digit release, DeQuervain release, hand or finger mass excision,
and hand or finger cyst excision. The magnitude of the increases in PR utilization
was small: between 2006 and 2017, the PR utilization increased by 1.4% for open carpal
tunnel release, 5.4% for trigger digit release, 2.9% for DeQuervain release, 10.1%
for hand or finger mass excision, and 6.5% for hand or finger cyst excision.
Conclusions
Despite the published benefits of the PR setting, we observed that the majority of
these 5 common minor hand surgeries are performed in the operation room setting. Between
2006 and 2017, the office-based PR utilization increased slightly. The identification
of barriers to PR utilization is needed to improve the value of care.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: October 28, 2022
Accepted:
August 17,
2022
Received:
January 5,
2022
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
