跨学科颅裂诊所早期耳科和听力评估中的健康社会决定因素。

IF 1.2 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Cleft Palate-Craniofacial Journal Pub Date : 2024-11-01 Epub Date: 2023-07-04 DOI:10.1177/10556656231186275
Daniel R Awad, Noel Jabbour, Matthew Ford, Jennifer L McCoy, Jesse A Goldstein, Joseph E Losee, Amber D Shaffer
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引用次数: 0

摘要

目的调查在跨学科模式下,医疗保健服务的社会经济指标与家庭对与耳裂相关的耳科和听力保健的依从性之间的关系:设计:回顾性病例系列:干预措施:干预措施:评估主要结果指标与地区贫困指数(ADI)、邮编家庭收入中位数、医院距离和保险状况之间的关系:对裂隙类型、门诊就诊年龄(裂隙、耳鼻喉科和听力科)和手术年龄(首次鼓室造口管插入术(TTI)、唇修复术和腭成形术)进行测量:大多数患者为男性(147/230,64%),患有唇腭裂(157/230,68%)。首次就诊唇裂、耳鼻喉科和听力科的中位年龄分别为 7 天、86 天和 5.9 个月。私人保险可降低未就诊率(p = .04)。有私人保险的患者首次到 CCC 就诊的年龄较小(p = .04),而居住地离医院较远的患者首次到 CCC 就诊的年龄较大(p = .002)。唇修复年龄与国家 ADI 呈正相关(p = .03)。然而,社会经济地位(SES)替代值或距离医院远近均与首次耳鼻喉科或听力检查或TTI的延迟无关:结论:一旦儿童在跨学科 CCC 中确立了地位,社会经济地位似乎对与耳裂相关的耳科和听力治疗影响不大。未来的工作应旨在阐明跨学科模式的哪些方面能最大限度地协调多系统的裂隙治疗,并增加高风险人群获得治疗的机会。
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Social Determinants of Health in Early Otologic and Audiologic Evaluation in an Interdisciplinary Cleft-Craniofacial Clinic.

Objective: Investigate associations between socioeconomic indicators of healthcare access with family compliance with cleft-related otologic and audiologic care within an interdisciplinary model.

Design: Retrospective case series.

Subjects and setting: Children born 2005-2015 who presented to the Cleft-Craniofacial Clinic (CCC) at a quaternary care children's hospital.

Interventions: Associations between main outcome measures and Area Deprivation Index (ADI), median household income for zip code, distance from hospital, and insurance status were evaluated.

Main outcome measures: Cleft types, ages at presentation to outpatient clinic (cleft, otolaryngology, and audiology), and ages at procedures (first tympanostomy tube insertion (TTI), lip repair, and palatoplasty) were measured.

Results: Most patients were male (147/230, 64%) with cleft lip and palate (157/230, 68%). Median age at first cleft, otolaryngology, and audiology visits were 7 days, 86 days, and 5.9 months, respectively. Private insurance predicted lower no-show rates (p = .04). Age at first CCC visit was younger for patients with private insurance (p = .04) and older for those who lived further from the hospital (p = .002). Age at lip repair was positively correlated with national ADI (p = .03). However, no socioeconomic status (SES) proxy or proximity to hospital was associated with delays in first otolaryngology or audiology examination or TTI.

Conclusion: Once children become established within an interdisciplinary CCC, SES appears to bear little influence on cleft-related otologic and audiologic care. Future efforts should aim to elucidate which aspects of the interdisciplinary model maximize multisystem cleft care coordination and increase access for higher risk populations.

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来源期刊
CiteScore
2.70
自引率
36.40%
发文量
215
期刊介绍: The Cleft Palate-Craniofacial Journal (CPCJ) is the premiere peer-reviewed, interdisciplinary, international journal dedicated to current research on etiology, prevention, diagnosis, and treatment in all areas pertaining to craniofacial anomalies. CPCJ reports on basic science and clinical research aimed at better elucidating the pathogenesis, pathology, and optimal methods of treatment of cleft and craniofacial anomalies. The journal strives to foster communication and cooperation among professionals from all specialties.
期刊最新文献
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