Interdisciplinary Craniofacial Teams Compared with Individual Providers: Is Orofacial Cleft Care more Comprehensive and Do Parents Perceive Better Outcomes?

Abstract

Objective The primary objective was to examine whether children with orofacial clefts received more comprehensive care and whether their parents perceived better outcomes if the care was delivered by interdisciplinary teams compared with individual providers. Design Data about services received and outcomes were collected from mothers of children with orofacial clefts. Participants Mothers of children born between 1998 and 2003 with orofacial clefts from Arkansas, Iowa, and New York who participated in the National Birth Defects Prevention Study were eligible. Main Outcome Measure(s) Services and treatments received and maternal perception of cleft care, health status, aesthetics, and speech were evaluated by team care status. Results Of 253 children, 24% were not receiving team care. Of those with cleft lip and palate, 86% were enrolled in team care. Compared with children with team care, those without had fewer surgeries and were less likely to have seen a dentist, received a hearing test, or had a genetic consultation. Mothers of children lacking team care were twice as likely to give lower ratings for overall cleft care; maternal perceptions of global health, facial appearance, and speech did not differ by team care status. Conclusions Recommended care tended to be received more often among those with team care. A larger, longitudinal study might answer questions about whether team care provides the best care and the role that type and severity of the condition and racial/ethnic differences play in the services received and outcomes experienced.