title: Socioeconomic influence on orofacial cleft patient care.
abstract: BACKGROUND
  Cleft lip and palate is the most common craniofacial birth defect in the UK. Orofacial clefts have functional and aesthetic implications requiring intensive multi-disciplinary follow-up to optimise development. Failure to attend follow-up is likely to have a negative impact on patient outcomes. The aim of this retrospective audit is to establish if socioeconomic status influences attendance, DNA and cancellation rates in cleft patients.
  
  
  RESULTS
  A retrospective audit of 74 orofacial cleft patients born and operated on at the Royal Hospital for Sick Children Glasgow between 2006 and 2007. There was higher rate of DNA in more deprived social groups-21% (SIMD 1) against 10% (SIMD 5). A higher rate of DNA in cleft lip and palate patients was noted. This group of patients showed a marked difference in attendance between SIMD 1 (38%) and SIMD 5 (78%).
  
  
  CONCLUSIONS
  More deprived areas have a higher outpatient DNA rate for cleft patients resulting in suboptimal follow-up. Ultimately, causation of poorer outcomes in this group is likely to be multi-factorial but the financial implication of travelling to multiple clinics should be considered and it may be that resource reallocation is the answer to address the current inequality of health care provision.
authors.affiliation: Speciality Registrar/Trainee Otolaryngology, Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, UK iansmillie@nhs.net.
authors.forename: I
authors.initials: I
authors.lastname: Smillie
authors.affiliation: Medical Student, School of Medicine, University of Glasgow, UK.
authors.forename: K
authors.initials: K
authors.lastname: Yong
authors.affiliation: Medical Student, School of Medicine, University of Glasgow, UK.
authors.forename: K
authors.initials: K
authors.lastname: Harris
authors.affiliation: Consultant Otolaryngology, Head & Neck Surgery, Royal Hospital for Sick Children, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Wynne
authors.affiliation: Consultant Plastic & Cleft Surgeon, Department of Plastic Surgery, Royal Hospital for Sick Children, UK.
authors.forename: C J H
authors.initials: CJ
authors.lastname: Russell
mesh_terms: D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D002675:Child, Preschool; D002971:Cleft Lip / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D002972:Cleft Palate / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D054869:Clinical Audit; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012606:Scotland; D012923:Social Class; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: DNA; SIMD; Socioeconomic; cleft; outcomes