"Travel Burden to ACPA Approved Cleft and Craniofacial Teams: A Geospatial Analysis".

Autor:	Brown MI; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA., Kuyeb BK; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA., Galarza LI; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.; Stephanie and Mitchell Morris Center for Cleft and Craniofacial Research and Innovation, Division of Plastic and Reconstructive Surgery, Children's of Mississippi, Jackson, Mississippi 39216, USA., Benedict KC; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.; Stephanie and Mitchell Morris Center for Cleft and Craniofacial Research and Innovation, Division of Plastic and Reconstructive Surgery, Children's of Mississippi, Jackson, Mississippi 39216, USA., Hoppe IC; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.; Stephanie and Mitchell Morris Center for Cleft and Craniofacial Research and Innovation, Division of Plastic and Reconstructive Surgery, Children's of Mississippi, Jackson, Mississippi 39216, USA., Humphries LS; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.; Stephanie and Mitchell Morris Center for Cleft and Craniofacial Research and Innovation, Division of Plastic and Reconstructive Surgery, Children's of Mississippi, Jackson, Mississippi 39216, USA.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Mar 25. Date of Electronic Publication: 2024 Mar 25.
DOI:	10.1097/PRS.0000000000011410
Abstrakt:	Background: Despite the existence of American Cleft Palate and Craniofacial Association (ACPA)-approved Cleft and Craniofacial Teams, access to multidisciplinary team-based care remains challenging for patients from rural areas, leading to disparities in care. We investigated the geospatial relationship between U.S. counties and ACPA-approved centers. Methods: The geographic location of all ACPA-approved cleft and craniofacial centers in the U.S. was identified. Distance between individual U.S. counties (n=3,142) and their closest ACPA-approved team was determined. Counties were mapped based on distance to nearest cleft or craniofacial team. Distance calculations were combined with U.S Census data to model the number of children served by each team and economic characteristics of families served. These relationships were analyzed using independent t-tests and ANOVA. Results: Over 40% of U.S. counties did not have access to an ACPA-approved craniofacial team within a 100-mile radius (n=1,267) versus 29% for cleft teams (n=909). Over 90% of counties greater than 100 miles to a craniofacial team had a population <7,500 (n=1,150). Of the counties >100 miles from a cleft team, 64% had a child poverty rate greater than national average (n=579). Counties with the highest birth rate and >100 miles to travel to an ACPA team are in the Mountain West. Conclusions: Given the time-sensitive nature of operative intervention and access to multidisciplinary care, the lack of equitable distribution in certified cleft and craniofacial teams is concerning. Centers may better serve families from distant areas by establishing satellite clinics, telehealth visits, and training local primary care providers in referral practices. Competing Interests: Financial Disclosure Statement: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. There are no funding sources to disclose. Authors have no significant conflicts of interest with any companies or organizations whose products or services may be discussed in this article. (Copyright © 2024 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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