Treatment of oralfacial clefts by state-affiliated craniofacial centers and cleft palate clinics.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Williams
Charles A
CA
Division of Genetics, Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida 32610, USA. willicx@peds.ufl.edu
Mardon
Russell E
RE
Grove
Douglas
D
Wharton
Paul
P
Hauser
Kimberlea W
KW
Frías
Jaime L
JL
D000015:Abnormalities, Multiple / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000601:surgery*; D044466:Asian People; D044383:Black People; D002675:Child, Preschool; D002869:Chromosome Aberrations / Q000139:chemically induced; D002971:Cleft Lip / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000601:surgery*; D002972:Cleft Palate / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000601:surgery*; D005260:Female; D005431:Florida / Q000453:epidemiology; D005568:Forms and Records Control / Q000706:statistics & numerical data; D006630:Hispanic or Latino; D006783:Hospitals, State; D006801:Humans; D007223:Infant; D008297:Male; D008423:Maternal Age; D008499:Medical Records / Q000706:statistics & numerical data; D010139:Pacific Islands / Q000208:ethnology; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012017:Referral and Consultation; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012744:Sex Ratio; D013723:Teratogens / Q000633:toxicity; D044465:White People; D001741:Black or African American
D013723:Teratogens