Location
LSU Health Sciences Center - New Orleans
Event Website
https://digitalscholar.lsuhsc.edu/surgery_s/
Document Type
Event
Start Date
4-5-2023 9:20 AM
End Date
4-5-2023 9:30 AM
Description
Background/Purpose: This project retrospectively assessed the cleft population at a regional cleft center using a standardized set of outcomes developed by the cleft team. Surgical data regarding age at primary cleft lip repair (PCLR), primary cleft palate repair (PCPR), and alveolar bone graft (ABG) was analyzed based on gender, race, payor status, and distance to treatment center.
Methods/Description: ICD-10 and CPT codes that correlated with cleft anomalies and surgical procedures of the lip and palate were used to generate a sample of 167 surgical procedures at a regional cleft center from April 2018 to May 2022. Linear regression analyses, Wilcoxon Rank-Sum, and Kruskal- Wallis tests were performed to identify differences in age at surgical repair based on gender, race, payor status, and distance to treatment center.
Results: The median age at PCLR was 5.2±2.6 months. There was no difference in age at PCLR based on gender or distance to treatment center. There is mild evidence suggesting patients identified as Asian had higher age at PCLR than those identified as White (one sided p = 0.05 < 0.1). Otherwise, no difference in age at PCLR was found based on race. There was significant evidence patients with financial assistance (FA) had higher age at PCLR than those with Medicaid (one sided p = 0.030 < 0.05), and mild evidence patients with FA had higher age at PCLR than those with commercial insurance (Com) (one sided p = 0.083 < 0.1).
The median age at PCPR was 1.4±0.8 years. There was no difference in age at PCPR based on gender or distance to treatment center. There was mild evidence suggesting the age at PCPR for patients identified as American Indian (AI) or Alaska Native (AN) was higher than for patients identified as African American (AA) and White separately, as the comparison between AA and AI or AN had an exact one- sided p = 0.059 < 0.1, and the comparison between White and AI or AN had an exact one-sided p = 0.089 < 0.1. Mild evidence suggested the age at PCPR for patients with Medicaid was higher than for patients with Com and those who used self-pay separately, as the comparison between Com and Medicaid had a one-sided p = 0.066 < 0.1, and the comparison between Self Pay and Medicaid had a one-sided p = 0.053 < 0.1.
The median age at ABG was 11.6±3.7 years. There was no difference in age at ABG based on gender, payor status, or distance to treatment center. Patients identified as AA had significantly higher age at ABG than patients identified as White (one-sided p value = 0.021 < 0.05), but no difference between AA and Asian (p value = 0.287).
Conclusions: In our patient sample, age at cleft surgery was not influenced by gender or distance to treatment center. However, age at cleft surgery was influenced by race and payor status (except for age at ABG). This study aims to elucidate areas of delayed care to focus future interventions and illuminate populations that require closer surveillance and care coordination.
Recommended Citation
Rimmer, Sarah; Richard, Jonathan; Fang, Zhide; Masoumy, Mohamad; Mount, Delora; and Fulton, Gregory, "An Analysis of Age at Cleft Surgery Based on Gender, Race, Distance from Treatment Center, and Payor Status" (2023). Surgery Research Symposium. 9.
https://digitalscholar.lsuhsc.edu/surgery_s/2023/postera/9
Included in
An Analysis of Age at Cleft Surgery Based on Gender, Race, Distance from Treatment Center, and Payor Status
LSU Health Sciences Center - New Orleans
Background/Purpose: This project retrospectively assessed the cleft population at a regional cleft center using a standardized set of outcomes developed by the cleft team. Surgical data regarding age at primary cleft lip repair (PCLR), primary cleft palate repair (PCPR), and alveolar bone graft (ABG) was analyzed based on gender, race, payor status, and distance to treatment center.
Methods/Description: ICD-10 and CPT codes that correlated with cleft anomalies and surgical procedures of the lip and palate were used to generate a sample of 167 surgical procedures at a regional cleft center from April 2018 to May 2022. Linear regression analyses, Wilcoxon Rank-Sum, and Kruskal- Wallis tests were performed to identify differences in age at surgical repair based on gender, race, payor status, and distance to treatment center.
Results: The median age at PCLR was 5.2±2.6 months. There was no difference in age at PCLR based on gender or distance to treatment center. There is mild evidence suggesting patients identified as Asian had higher age at PCLR than those identified as White (one sided p = 0.05 < 0.1). Otherwise, no difference in age at PCLR was found based on race. There was significant evidence patients with financial assistance (FA) had higher age at PCLR than those with Medicaid (one sided p = 0.030 < 0.05), and mild evidence patients with FA had higher age at PCLR than those with commercial insurance (Com) (one sided p = 0.083 < 0.1).
The median age at PCPR was 1.4±0.8 years. There was no difference in age at PCPR based on gender or distance to treatment center. There was mild evidence suggesting the age at PCPR for patients identified as American Indian (AI) or Alaska Native (AN) was higher than for patients identified as African American (AA) and White separately, as the comparison between AA and AI or AN had an exact one- sided p = 0.059 < 0.1, and the comparison between White and AI or AN had an exact one-sided p = 0.089 < 0.1. Mild evidence suggested the age at PCPR for patients with Medicaid was higher than for patients with Com and those who used self-pay separately, as the comparison between Com and Medicaid had a one-sided p = 0.066 < 0.1, and the comparison between Self Pay and Medicaid had a one-sided p = 0.053 < 0.1.
The median age at ABG was 11.6±3.7 years. There was no difference in age at ABG based on gender, payor status, or distance to treatment center. Patients identified as AA had significantly higher age at ABG than patients identified as White (one-sided p value = 0.021 < 0.05), but no difference between AA and Asian (p value = 0.287).
Conclusions: In our patient sample, age at cleft surgery was not influenced by gender or distance to treatment center. However, age at cleft surgery was influenced by race and payor status (except for age at ABG). This study aims to elucidate areas of delayed care to focus future interventions and illuminate populations that require closer surveillance and care coordination.
https://digitalscholar.lsuhsc.edu/surgery_s/2023/postera/9