Sirikul Wachiranun, Buawangpong Nida, Isaradech Natthanaphop, Sirimaharaj Wimon, Charoenvicha Chirakan, Gomez Laura H, Yao Caroline, Torres Natalie, Khwanngern Krit
From the Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Thailand.
Department of Biomedical Informatics and Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, Thailand.
Plast Reconstr Surg Glob Open. 2025 Jul 18;13(7):e6966. doi: 10.1097/GOX.0000000000006966. eCollection 2025 Jul.
Cleft lip and palate have a significant impact on individuals' lives, and timely evaluation and treatment are crucial for long-term outcomes and quality of life.
Northern Thailand's Cleft Lip and Cleft Palate Healthcare Network provides comprehensive and timely evaluation and care. A retrospective cohort study conducted between 2015 and 2023 used secondary data from the network to analyze time-to-evaluation and treatment and factors associated with these outcomes before (before 2016), during (2016-2018), and after (2019-2023) the network's establishment.
The median time to the first evaluation decreased from 107 months (95% confidence interval 101-116) before the network's establishment to 4 months (95% confidence interval 3-5) in the recent birth cohort. Despite these reductions, the timeframes for the first evaluation and cleft lip repair did not meet the desired standards of less than 1 and 3-5 months, respectively. The recent birth cohort had a much shorter time to cleft palate repair, 9-18 months. However, only 23.2% of patients underwent cleft palate repair. Evaluation times for otitis media did not improve across birth cohorts, and dental care and access to speech therapy remained inadequate at 52.0% and 16.9%, respectively.
Integrative healthcare, informatics, and knowledge management have improved treatment outcomes at the Northern Thailand Cleft Lip and Cleft Palate Healthcare Network. However, the low number of treated patients shows the need to improve access and long-term outcomes. Focusing on these areas is crucial to maintaining and expanding the network's positive impact on patient care and quality of life.
唇腭裂对个人生活有重大影响，及时评估和治疗对长期预后及生活质量至关重要。
泰国北部唇腭裂医疗保健网络提供全面且及时的评估与护理。一项在2015年至2023年期间进行的回顾性队列研究，利用该网络的二手数据，分析了在网络建立之前（2016年之前）、期间（2016 - 2018年）和之后（2019 - 2023年）的评估和治疗时间以及与这些结果相关的因素。
首次评估的中位时间从网络建立前的107个月（95%置信区间101 - 116）降至最近出生队列中的4个月（95%置信区间3 - 5）。尽管有这些减少，但首次评估和唇裂修复的时间框架分别未达到期望的标准，即少于1个月和3 - 5个月。最近出生队列的腭裂修复时间要短得多，为9 - 18个月。然而，只有23.2%的患者接受了腭裂修复。各出生队列中中耳炎的评估时间没有改善，牙科护理和言语治疗的可及性仍然不足，分别为52.0%和16.9%。
综合医疗保健、信息学和知识管理改善了泰国北部唇腭裂医疗保健网络的治疗结果。然而，接受治疗的患者数量较少表明需要改善可及性和长期预后。关注这些领域对于维持和扩大该网络对患者护理和生活质量的积极影响至关重要。
