Factors associated with distance and time traveled to cleft and craniofacial care

Author:

Cassell Cynthia H.1,Krohmer Anne12,Mendez Dara D.3,Lee Kyung A.14,Strauss Ronald P.5,Meyer Robert E.6

Affiliation:

1. National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta Georgia

2. University of Minnesota School of Public Health, University of Minnesota Minneapolis Minnesota

3. Graduate School of Public Health University of Pittsburgh Pittsburgh Pennsylvania

4. Northrop Grumman Information Systems Atlanta Georgia

5. Office of Executive Vice Chancellor and Provost and Departments of Dental Ecology, Epidemiology, and Social Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina

6. North Carolina Birth Defects Monitoring Program State Center for Health Statistics North Carolina Division of Public Health Raleigh North Carolina

Abstract

BACKGROUNDInformation on travel distance and time to care for children with birth defects is lacking. We examined factors associated with travel distance and time to cleft care among children with orofacial clefts.METHODSIn 2006, a mail/phone survey was administered in English and Spanish to all resident mothers of children with orofacial clefts born 2001 to 2004 and identified by the North Carolina birth defects registry. We analyzed one‐way travel distance and time and the extent to which taking a child to care was a problem. We used multivariable logistic regression to examine the association between selected sociodemographic factors and travel distance (≤60 miles and >60 miles) and time (≤60 min and >60 min) to cleft care.RESULTSOf 475 eligible participants, 51.6% (n = 245) responded. Of the respondents, 97.1% (n = 238) were the child's biological mother. Approximately 83% (n = 204) of respondents were non‐Hispanic White; 33.3% (n = 81) were college educated; and 50.0% (n = 115) had private health insurance. One‐way mean and median travel distances were 80 and 50 miles, respectively (range, 0–1058 miles). One‐way mean and median travel times were 92 and 60 min, respectively (range, 5 min to 8 hr). After adjusting for selected sociodemographics, travel distance varied significantly by maternal education, child's age, and cleft type. Travel time varied significantly by child's age. Approximately 67% (n = 162) reported taking their child to receive care was not a problem.CONCLUSIONApproximately 48% of respondents traveled > 1 hr to receive cleft care. Increasing access to care may be important for improving health outcomes among this population Birth Defects Research (Part A) 97:685–695, 2013. © 2013 Wiley Periodicals, Inc.

Publisher

Wiley

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4. American Cleft Palate‐Craniofacial Association (ACPA).2009.Parameters for evaluation and treatment of patients with cleft lip/palate and other craniofacial anomalies. Revised edition. Chapel Hill NC: 1–34. available at:http://www.acpa‐cpf.org/uploads/site/Parameters_Rev_ 2009.pdf. Accessed March 24 2013.

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