Comparing Access Barriers to Orofacial Cleft Care: A Multicenter Study Across Two U.S. Children's Hospitals

Area of Science:

• Craniofacial Medicine
• Health Services Research
• Pediatric Healthcare

Background:

• Orofacial clefts require specialized, multidisciplinary care.
• Access to this care can be hindered by various patient- and system-level factors.
• Understanding perceived barriers is essential for improving care delivery.

Purpose of the Study:

• To compare perceived barriers to craniofacial cleft care between two distinct pediatric hospital settings.
• To identify specific financial, social, geographic, and language-related obstacles.
• To inform strategies for enhancing equitable access to cleft care.

Main Methods:

• A cross-sectional, multisite survey of 172 parents/guardians of children with orofacial clefts.
• Survey assessed financial, social, geographic, and language barriers.
• Multivariate logistic regression analyzed factors influencing perceived access barriers.

Main Results:

• Significant regional differences in insurance coverage and family demographics were observed.
• Difficulty finding nearby specialists was the most common barrier at both sites (73.3% NCH, 78.1% CHP).
• Language barriers (Spanish-only speakers) and being a father were significant predictors of perceived access barriers.

Conclusions:

• Perceived barriers to craniofacial cleft care vary significantly by region.
• Addressing disparities in insurance, language support, and specialist availability is vital.
• Targeted interventions are needed to ensure equitable care for all children with orofacial clefts.