title: Minority and Public Insurance Status: Is There a Delay to Alveolar Bone Grafting Surgery?
abstract: This study sought to determine the timing of alveolar bone grafting (ABG) surgery among children with cleft lip with or without cleft palate (CL±P) with regard to race and insurance status.
  
  
  
  A retrospective chart review of consecutive patients receiving ABG surgery was conducted. A multivariate regression model was constructed using predetermined clinical and demographic variables.
  
  
  
  A large, urban cleft referral center.
  
  
  
  Nonsyndromic patients with CL±P were eligible for study inclusion.
  
  
  
  ABG surgery using autogenous bone harvested from the anterior iliac crest.
  
  
  
  The primary outcome of interest was age at ABG surgery.
  
  
  
  A total of 233 patients underwent ABG surgery at 8.1 ± 2.3 years of age. African American and Hispanic patients received delayed ABG surgery compared with Caucasian patients by approximately 1 year (P < .05). There was no difference in ABG surgery timing by insurance status (P > .05).
  
  
  
  The timing of ABG surgery varied by race but not by insurance status. Greater resources may be needed to ensure timely delivery of cleft care to African American and Hispanic children.
authors.forename: Jason
authors.initials: J
authors.lastname: Silvestre
authors.forename: Marten N
authors.initials: MN
authors.lastname: Basta
authors.forename: John P
authors.initials: JP
authors.lastname: Fischer
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Lowe
authors.forename: Rosario
authors.initials: R
authors.lastname: Mayro
authors.forename: Oksana
authors.initials: O
authors.lastname: Jackson
mesh_terms: D064728:Alveolar Bone Grafting / Q000191:economics / Q000379:methods*; D002648:Child; D002971:Cleft Lip / Q000191:economics / Q000208:ethnology / Q000601:surgery*; D002972:Cleft Palate / Q000191:economics / Q000208:ethnology / Q000601:surgery*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007085:Ilium / Q000637:transplantation; D019458:Insurance Coverage; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors
keywords: African American; Hispanic; cleft lip and palate; health care disparities; pediatrics; race