Where Did Service Members Undergo Carpal Tunnel Releases During COVID-19? — SOMOS 64th Annual Meeting

Smith M, Huszar M, Pav V, Hando B, Deal J, Yuan X

Abstract submitted to SOMOS 64h Annual Meeting

Carpal Tunnel Syndrome (CTS) is the most common peripheral entrapment neuropathy, impacting the health, performance, and readiness of Active-Duty service members (ADSMs) of the U.S. Military. However, for ADSMs who seek surgical management for severe or refractory CTS with Carpal Tunnel Release (CTR), access to subspecialty providers within direct care (DC) Military Treatment Facilities (MTFs) can be limited, leading to reliance on care outside MTFs within the private sector (PS). It is currently unknown how the COVID-19 pandemic has impacted provision of and access to care for CTS and CTRs across DC and PS. Therefore, the purpose of this study is to describe regional trends and variation in CTRs performed across Defense Health Agency (DHA) markets within the Military Health System (MHS) over Fiscal Years (FY) 2019-2021. All study procedures were approved by the Uniformed Services University’s Institutional Review Board. We queried the MHS Data Repository to identify all ADSMs with outpatient encounters in DC and PS by International Classification of Diseases, Tenth Revision diagnosis codes for CTS, and CTRs by Current Procedural Terminology codes, during FYs 2019-2021. We further classified CTRs by FY, DC vs. PS, DHA markets, and setting [e.g., Ambulatory Surgical Center (ASC), clinic]. PS encounters were derived using per person per day logic and mapped to DHA markets by zip codes within 40 miles of MTF Service Areas.