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Treatment Outcomes of Cleft Lip and Cleft Palate Healthcare Network in Northern Thailand
Wachiranun Sirikul1,2,3, Nida Buawangpong4, Natthanaphop Isaradech1,5
1From the Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Thailand.
Background:
Cleft lip and palate have a significant impact on individuals' lives, and timely evaluation and treatment are crucial for long-term outcomes and quality of life.
Methods:
Northern Thailand's Cleft Lip and Cleft Palate Healthcare Network provides comprehensive and timely evaluation and care. A retrospective cohort study conducted between 2015 and 2023 used secondary data from the network to analyze time-to-evaluation and treatment and factors associated with these outcomes before (before 2016), during (2016-2018), and after (2019-2023) the network's establishment.
Results:
The median time to the first evaluation decreased from 107 months (95% confidence interval 101-116) before the network's establishment to 4 months (95% confidence interval 3-5) in the recent birth cohort. Despite these reductions, the timeframes for the first evaluation and cleft lip repair did not meet the desired standards of less than 1 and 3-5 months, respectively. The recent birth cohort had a much shorter time to cleft palate repair, 9-18 months. However, only 23.2% of patients underwent cleft palate repair. Evaluation times for otitis media did not improve across birth cohorts, and dental care and access to speech therapy remained inadequate at 52.0% and 16.9%, respectively.
Conclusions:
Integrative healthcare, informatics, and knowledge management have improved treatment outcomes at the Northern Thailand Cleft Lip and Cleft Palate Healthcare Network. However, the low number of treated patients shows the need to improve access and long-term outcomes. Focusing on these areas is crucial to maintaining and expanding the network's positive impact on patient care and quality of life.
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