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Current national incidence, trends, and health care resource utilization of cleft lip-cleft palate

Benjamin Basseri1, Benjamin D Kianmahd, Jason Roostaeian

  • 1Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine at the University of California, Los Angeles.

Plastic and Reconstructive Surgery
|March 3, 2011
PubMed

Insights

Pediatric cleft care is increasingly concentrated in teaching hospitals, leading to higher costs but fewer complications. This national trend impacts resource allocation and patient outcomes.

Area of Science:

  • Craniofacial surgery
  • Pediatric health outcomes
  • Health services research

Background:

  • Epidemiological data on cleft lip, cleft palate, and cleft lip-cleft palate are inconsistent and limited to regional studies.
  • There is a need for current national data and analysis of recent trends in pediatric cleft care.

Purpose of the Study:

  • To analyze national trends in pediatric orofacial cleft discharges from 1997 to 2007.
  • To examine patient and hospital characteristics, including care utilization, charges, hospital type, and adverse events.
  • To identify significant trends in cleft care over the study period.

Main Methods:

  • Utilized the Kids' Inpatient Database (KID) for national data on pediatric cleft discharges (1997-2007).
  • Analyzed patient and hospital-level data to compare groups regarding care use, charges, hospital type, and complications.
  • Conducted a trend analysis over the 6-year study period.

Main Results:

  • Cleft operations increased at teaching hospitals (13.4%) while decreasing at nonteaching hospitals (15.8%).
  • Mean overall hospital charges increased by 74.5% (p < 0.001), outpacing aggregate charge increases (60%).
  • Teaching hospitals showed lower perioperative complication rates (14-27% less) than nonteaching hospitals from 2000-2007.

Conclusions:

  • A clear trend shows pediatric cleft patients are increasingly treated at teaching hospitals.
  • This shift is associated with higher healthcare costs and reduced perioperative complications.
  • Understanding these trends is crucial for physicians and policymakers to address disparities in resource use and optimize patient care.
Abstract

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