Navigating the Intersection of Evidence and Policy in Hand Surgery Practice

Baxter, Natalie B; Chung, Kevin C.

doi:10.1016/j.hcl.2020.01.001

Cited by 1 publication

(8 citation statements)

References 37 publications

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“…32 Resource limitations may prevent patients from traveling a greater distance to a hand specialist who is willing to provide treatment. 2,33 In fact, no-show rates increase with the greater distance required to reach a tertiary hand care center. 7 Consequently, patients who must travel long distances for their treatment often demonstrate poorer outcomes.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…1 Multiple studies have found that complaints related to the hand are among the most prevalent reasons for presentation to an emergency department. [1][2][3] Hand injuries are often lacerations, occur due to occupational hazards, and in a younger population. 3 In addition, the prevalence of nontraumatic hand disorders such as carpal tunnel syndrome and trigger finger are on the rise in the United States.…”

Section: Introductionmentioning

confidence: 99%

“…10 The creation of policy is a dynamic process, requiring analysis of quantitative and qualitative evidence from clinical investigations, public health research, and even narrative accounts. 2 Several reforms in health care make it a challenging environment in which policy makers and leaders must navigate while seeking to improve patient outcomes, satisfaction, and efficient use of limited resources. 9 Not only is it critical for individual providers to fully understand barriers in optimal delivery of care to patients having hand surgery, but it is also imperative for providers to be involved in implementing solutions to these challenges despite limitations present in the current health care environment.…”

Section: Introductionmentioning

confidence: 99%

“…Considering that traumatic injuries, and musculoskeletal disorders, such as carpal tunnel syndrome, often transpire in the workplace, the downstream effects of loss of productivity are substantial. 2 Limitations in access to hand surgical care remains a prominent concern across the United States. Understanding the factors that hinder access to reconstructive hand care will enable the implementation of proper health care reform for improved health outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Access to Reconstructive Hand Surgery in the United States—Investigating the Obstacles: A Scoping Review

Kohan

Mangan

Patel

2022

Hand (New York, N,Y.)

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Background: Mechanisms that affect access to surgical hand care appear to be complex and multifaceted. This scoping review aims to investigate the available literature describing such mechanisms and provide direction for future investigation. Methods: The methodological framework outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews was used to guide this review. In November 2021, MEDLINE and EMBASE databases were searched. A narrative summary of the characteristics and key findings of each paper is used to present the data to facilitate the integration of diverse evidence. Results: Of 471 initial studies, 49 were included in our final analysis. Of these, 33% were cohort studies; 27% reported that underinsured patients are less likely to get an appointment with a hand specialist or to receive treatment. Overburdened emergency departments accounted for the second-most reported reason (16%) for diminished access to surgical hand care. Elective procedure financial incentives, poor emergency surgical hand coverage, distance to treatment, race, and policy were also notably reported across the literature. Conclusions: This study describes the vast mechanisms that hinder access to surgical hand care and highlights their complexity. Possible solutions and policy changes that may help improve access have been described.

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