Delay in Cleft Lip and Palate Surgical Repair
| Autor: | Pravin K. Patel, Kirstie K. Danielson, Perry S Bradford, Rebekah M Zaluzec, Janine Rosenberg, Katherine A. Rodby |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Urban Population Cleft Lip Population Ethnic group MEDLINE Cleft surgery 03 medical and health sciences 0302 clinical medicine medicine Humans Craniofacial 030223 otorhinolaryngology education Retrospective Studies Surgical repair education.field_of_study business.industry Infant Newborn Infant Retrospective cohort study 030206 dentistry General Medicine Health equity Cleft Palate Otorhinolaryngology Female Surgery Health Facilities business Delivery of Health Care |
| Zdroj: | Journal of Craniofacial Surgery. 30:2328-2331 |
| ISSN: | 1049-2275 |
| DOI: | 10.1097/scs.0000000000005740 |
| Popis: | Access to specialized medical care is critical to decrease complications and minimize long-term morbidity, yet racial disparities in cleft surgery persist as time to initial reconstruction remains delayed among minority patients. Research has demonstrated an average 3-week delay in surgery for minority patients nationally. A retrospective chart review of patient demographics, visit timing, and surgical history was performed for patients who underwent primary cleft lip with or without palate (CL + P) reconstruction between 2002 and 2016 at an urban craniofacial center. Of the 89 children who underwent surgery, 87% were ethnic minorities (58% Hispanic, 25% African-American, 4% Asian/Other). Caucasian children were the earliest to receive CL (3.5 months) and CP (13-months) repair. Minority children trended toward a delay in CL repair, with surgery for African-Americans at 5-months (P = 0.06) and Hispanics at 4.8-months (P = 0.07). Time from first visit to CL surgery showed significant delays for minority, non-English speaking, and public insurance patients; however, for CP repair, male children were delayed from first visit to surgery compared to females (P = 0.03). While there was no statistical difference in age at CL or CP surgical repair among our racial/ethnic cohorts, there were significant racial/ethnic differences in timing spent in the preoperative period for CL. However, racial/ethnic differences decreased as the patients spent more time within the healthcare system. Thus, established, interdisciplinary cleft/craniofacial centers well versed in minority patients can minimize the complex social and cultural factors that contribute to delays in cleft care. |
| Databáze: | OpenAIRE |
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