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Improving patient follow-up in developing regions.

Leigh A Jansen1, Leonardo Carillo, Lisa Wendby

  • 1From the *Plastic Surgery, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; †Operation Smile India, Mahendra Mohan Choudhury Hospital, Panbazar, Guwahati, India; and ‡Operation Smile, Virginia Beach, Virginia.

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Summary
This summary is machine-generated.

Implementing outreach cleft care follow-up programs in developing regions significantly reduces patient costs and financial burden. These programs improve access to essential cleft surgery care, demonstrating successful adaptations for underserved populations.

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Area of Science:

  • Global Health
  • Surgical Care
  • Public Health Interventions

Background:

  • Cleft surgery follow-up presents significant challenges in developing regions.
  • The Guwahati Comprehensive Cleft Care Centre (GC4) in Assam, India, offers a model for addressing these challenges.

Purpose of the Study:

  • To evaluate the rates, costs, and patient satisfaction of two distinct cleft surgery follow-up programs.
  • To assess the impact of an outreach follow-up model compared to traditional center-based care.

Main Methods:

  • Analysis of 10,582 postoperative visits from May 2011 to November 2013.
  • Administration of questionnaires to assess patient experience and costs.
  • Calculation of direct costs, lost income, and financial burden for both follow-up models.

Main Results:

  • 85% of patients utilized center-based follow-up, while 15% used local outreach programs.
  • Local follow-up significantly reduced patient costs (Rs 299 vs. Rs 911), lost income (Rs 143 vs. Rs 367), and financial burden (P=0.003).
  • Patient satisfaction and likelihood of attending follow-up showed no significant differences between models, while follow-up rates increased substantially after program revisions.

Conclusions:

  • Process changes and outreach programs can significantly improve cleft care outcomes in resource-limited settings.
  • The study highlights the potential of adapted care models to enhance cost-effectiveness and accessibility of cleft surgery follow-up.
  • Findings have broad implications for improving surgical care delivery in developing countries worldwide.