Orthotic Helmet Therapy for Deformational Plagiocephaly: Stratifying Outcomes by Insurance.

Autor:	Hauc SC; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Junn AH; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Long AS; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Rivera JC; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Littlefield TR; Cranial Technologies, Inc., 1395W. Auto Drive, Tempe, AZ, USA., Ihnat JM; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Shah HP; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Pondugula N; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Almeida MN; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Alper DP; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Persing JA; Division of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Alperovich M; Division of Plastic Surgery, Yale School of Medicine, 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] 2024 Jun; Vol. 61 (6), pp. 1027-1032. Date of Electronic Publication: 2023 Jan 18.
DOI:	10.1177/10556656231152517
Abstrakt:	Objective: Deformational Plagiocephaly (DP) is commonly treated with cranial orthosis, or helmet therapy. A large, national study on the impact of insurance status on helmet outcomes is lacking. We assessed treatment outcomes for helmet therapy based on insurance status. Design: This was a retrospective data analysis of patients referred to Cranial Technologies, Inc for helmet therapy between 2014-2020 across 21 states. Patients, Participants: There were a total of 211,417 patients referred for helmeting, of whom 141,513 received helmet therapy. Main Outcomes Measures: Multivariate regression was used to assess the relationship of insurance status with post-treatment residual flattening, measured by cephalic index (CI) and cranial vault asymmetry index (CVAI), and treating provider rating of success. Results: Patients with Medicaid were more likely to complete treatment with residual flattening measured by CI and CVAI when compared to patients with private insurance (OR: 1.58, CI: 1.51-1.65, p < 0.001 and OR: 1.21, CI: 1.15-1.28, p < 0.001, respectively). Providers of patients with Medicaid were more likely to give a low rating of success following treatment (OR: 3.25, CI: 2.70-3.92, p < 0.001). Conclusions: Our study investigating the impact of insurance status on helmet therapy across 21 states found that patients with Medicaid were more likely to experience residual flattening and have lower provider-rated outcomes compared to those with commercial insurance. Given significant caregiver burden posed by helmet therapy, which requires frequent visits and consistent helmet use, caregivers of patients with Medicaid may require greater support to reduce outcome disparities observed here. Competing Interests: Declaration of Conflicting InterestsMr. Littlefield is the Chief Science and Technology Officer at Cranial Technologies, Inc., and he has a financial interest in Cranial Technologies, Inc. All other authors have no conflicts of interest relevant to this article to disclose.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu