Williams Charles A, Mardon Russell E, Grove Douglas, Wharton Paul, Hauser Kimberlea W, Frías Jaime L
Division of Genetics, Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida 32610, USA.
Birth Defects Res A Clin Mol Teratol. 2003 Sep;67(9):643-6. doi: 10.1002/bdra.10115.
Oralfacial clefting (OFC) disorders require expedient evaluation and treatment to obtain optimal outcome. In Florida, there is a statewide program targeted to the care of infants with OFC. We therefore sought to determine statewide referral and treatment patterns of children born with OFC identified through the Florida Birth Defects Registry.
Using data for 1996 and 1997 and ICD-9 CM codes 749.00 - 749.25, we identified 539 OFC cases. All cases were matched with the evaluation and treatment records of the statewide Children's Medical Services' (CMS) craniofacial centers (CFC) and cleft palate clinics (CPC). The likelihood of CMS contact was examined with respect to demographic and other descriptive data characterizing the OFC cases.
42% (227/539) of OFC cases were evaluated at or known to the CFC or CPC. Children with cleft lip and palate were more likely to have had contact than were those with cleft lip or cleft palate alone. The CFC and CPC programs were most likely to provide evaluation between age 2 months and 3 years. Of 12 counties with occurrences of more than 15 OFC cases, 2 had significantly lower contact rates, suggesting possible problems in accessibility or reporting of services.
Statewide Birth Defect Registry data can be used in collaboration with statewide treatment programs to gain insight into referral patterns and provision of services. Factors influencing access to services and quality of care, though not addressed by this study, could be prospectively incorporated into such a project.
口腔面部裂(OFC)疾病需要迅速评估和治疗以获得最佳治疗效果。在佛罗里达州,有一个针对OFC婴儿护理的全州性项目。因此,我们试图确定通过佛罗里达州出生缺陷登记处识别出的患有OFC的儿童的全州转诊和治疗模式。
利用1996年和1997年的数据以及国际疾病分类第九版临床修正版(ICD - 9 CM)编码749.00 - 749.25,我们识别出539例OFC病例。所有病例均与全州儿童医疗服务(CMS)颅面中心(CFC)和腭裂诊所(CPC)的评估和治疗记录相匹配。根据表征OFC病例的人口统计学和其他描述性数据,检查了与CMS接触的可能性。
42%(227/539)的OFC病例在CFC或CPC接受了评估或为其所知。唇腭裂患儿比单纯唇裂或腭裂患儿更有可能接受过相关接触。CFC和CPC项目最有可能在2个月至3岁之间提供评估。在出现15例以上OFC病例的12个县中,有2个县的接触率明显较低,这表明在服务可及性或报告方面可能存在问题。
全州出生缺陷登记处的数据可与全州治疗项目协作使用,以深入了解转诊模式和服务提供情况。本研究虽未涉及影响服务可及性和护理质量的因素,但可前瞻性地将这些因素纳入此类项目。