Disparities in Access to Cranial Remodeling Orthosis for Deformational Plagiocephaly.

Autor:	Junn A; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Dinis J; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Long A; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Hauc S; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Phillips S; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Junn AH; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Reategui A; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Lopez J; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Persing JA; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA., Alperovich M; Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA.
Jazyk:	angličtina
Zdroj:	The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2023 Apr; Vol. 60 (4), pp. 454-460. Date of Electronic Publication: 2021 Dec 30.
DOI:	10.1177/10556656211069816
Abstrakt:	Objective: Moderate to severe cases of deformational plagiocephaly (DP) may be treated with cranial remolding orthoses (CRO). This study investigated the socioeconomic disparities in access to care for CRO for DP correction. Design: This was a retrospective review of medical records from a single CRO company in Connecticut from 2014 to 2020. Methods: Demographic variables were collected from all patients. Univariable logistic regressions were used to identify differences for presenting age at consultation, whether CRO was pursued, and length of CRO treatment by insurance payor and household income quartile. Results: Of the 5620 patients identified, 4100 (73.0%) received CRO, with 674 (12.0%) receiving a second helmet. Of those receiving CRO, 1536 (37.5%) had Medicaid insurance while 2558 (62.4%) were commercially insured. Patients on Medicaid were 1.30 times more likely to have delayed presentation ( P   =  .017), while patients from the lowest income quartile were 1.26 1.50 ( P  < .001) and 1.58 ( P  < .001) times more likely to have a delayed presentation relative to those in the highest and second-highest income quartiles, respectively. Patients in the highest and second-highest income quartiles were also 1.55 ( P  < .001) and 1.45 ( P  < .001) more likely, respectively, to receive CRO after consultation than those from the lowest income quartile. Conclusions: Lower income and Medicaid-insured patients had delayed presentation for CRO consultation. Those from the lowest income quartile were more likely to never receive CRO than those from wealthier backgrounds. Low socioeconomic status and Medicaid insurance, which can have more restrictive coverage policies for CRO, may result in the delayed treatment of DP.
Databáze:	MEDLINE
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