Costs, Complications Up for Minorities in Cleft Palate Repair

Racial-minority populations incur higher costs and experience higher rates of complications in cleft palate repair, according to a study published in the June issue of Plastic and Reconstructive Surgery.

Robin T. Wu, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues examined the impact of race on admissions, hospital costs, and short-term complications in cleft palate repair in a cohort of 3,464 whites, 1,428 Hispanics, 413 blacks, 398 Asian/Pacific Islanders, and 470 patients of other races.

The researchers found that more emergent admissions and increased length of stay were experienced by black patients. Black and Hispanic patients had the highest hospital charges, while white patients had the lowest hospital charges. More total complications were reported for black than nonblack patients, including higher rates of postoperative fistula and nonspecific complications among revision repairs. In the primary cohort, Asian/Pacific Islander patients experienced higher rates of accidental puncture and fistula. The highest rates of wound disruption were experienced by patients of other races. Length of stay and age were associated with increases in total complications and costs after adjustment for race and other confounding variables.

"We believe that in addition to influencing the management of cleft palate, this research gives needed attention to the social determinants of health -- an influential yet understudied component of surgical care that is important for plastic surgeons of all specialties to consider and understand," a coauthor said in a statement.

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