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- Title
Socioeconomic Disparities in Cleft Lip Care.
- Authors
Kalmar, Christopher L.; Malphrus, Elizabeth L.; Kosyk, Mychajlo S.; Zapatero, Zachary D.; Taylor, Jesse A.
- Abstract
Objective: The purpose of this study was to utilize a multicenter dataset to elucidate whether socioeconomic factors were associated with access to cleft lip surgery, treatment by higher-volume providers, and family choice for higher-volume centers. Design: Retrospective cohort study. Setting: Hospitals participating in the Pediatric Health Information System. Patients: Primary cleft lip repair performed in the United States between 2010 and 2020. Outcomes: Travel distance, hospital volume, hospital choice. Results: During the study interval, 8954 patients underwent unilateral (78.4%, n = 7021) or bilateral (21.6%, n = 1933) primary cleft lip repair. Patients with unilateral cleft lip were repaired significantly earlier if they were White (P <.001) and significantly later if they lived in an urban community (P =.043). Similarly, patients with bilateral cleft lip were repaired significantly earlier if they were White (P <.001). Patients from above-median income households (P =.011) and living in urban communities (P <.001) were significantly more likely to be treated at high-volume hospitals, whereas those living in underserved communities (P <.001) were significantly less likely to be treated at high-volume hospitals. White patients were significantly more likely to be treated by high-volume surgeons (P <.001). Patients with White race were significantly more likely to choose a higher-volume hospital than the one most locally available (P <.001). Conclusions: Patients with White race are more likely to travel farther and be treated by high-volume surgeons although at smaller hospitals. Patients from underserved areas travel significantly farther for cleft care and are treated at lower-volume hospitals. Patients in urban communities have shorter travel distances and are treated at higher-volume hospitals.
- Subjects
UNITED States; CONFIDENCE intervals; CHILDREN'S hospitals; RACE; POPULATION geography; RETROSPECTIVE studies; HEALTH information systems; SOCIOECONOMIC factors; CLEFT lip; PATIENTS' attitudes; DESCRIPTIVE statistics; HEALTH equity; METROPOLITAN areas; LONGITUDINAL method
- Publication
Cleft Palate Craniofacial Journal, 2023, Vol 60, Issue 6, p657
- ISSN
1055-6656
- Publication type
Article
- DOI
10.1177/10556656221078488