Six-year Burden of Care for Nonsyndromic Unilateral Cleft Lip and Palate Patients: A Comparison Between Cleft Centers and Noncleft Centers

Abstract

Objective To determine differences in burden of care between nonsyndromic patients with unilateral cleft lip and palate undergoing treatment at American Cleft Palate-Craniofacial Association (ACPA)-accredited centers and nonaccredited centers in New York State. Design A retrospective review of the New York Statewide Planning and Research Cooperative System database from January 2001 to December 2014 was performed using ICD-9 and CPT coding. Patients, participants This study included patients with unilateral cleft lip and palate who underwent both lip and palate repairs during their first  6 years of life. Exclusion criteria included orofacial cleft syndromes, follow-up under  6 years, and one-stage combined cleft lip and palate repairs. Results Eighty-eight patients were treated at cleft centers, and 29 patients at nonaccredited centers (   n = 117). Age at primary palatoplasty (13.0 months vs 18.1 months;    p = .019), total number of cleft operations (2.3 vs 2.7;    p = .012), and total number of primary cleft-specific procedures (2.2 vs 2.5;    p = .0049) were significantly lower for patients treated in cleft centers. Age at primary cheiloplasty (4.8 months vs 4.6 months;    p = .865), post-cheiloplasty length of stay (1.2 days vs 1.2 days;    p = .673), post-palatoplasty length of stay (1.5 days vs 1.9 days;    p = .211), average hospital admissions (2.2 vs 2.3; p = 0.161), and total complication rates (34.1% vs 21.1%; p = 0.517) did not differ significantly between cleft centers and noncenters. Conclusions This data demonstrates some significant differences in overall 6 year burden of care for nonsyndromic patients with unilateral cleft lip and palate treated at ACPA-accredited cleft centers versus nonaccredited centers.