Cleft Lip And Cleft Palate Surgeries In The United States

Objectives: The objective of this study is to provide nationally representative estimates of cleft lip and cleft palate corrections performed in the United States during the years 2000 through 2008.

Methods: The Nationwide Inpatient Sample for the years 2000 through 2008 was used. All hospitalizations that had a cleft lip repair or cleft palate repair/revision were selected. Estimates of concomitant procedures performed during the index hospitalization were obtained. The demographic characteristics of patients undergoing these procedures were examined. Outcomes assessed included discharge status following surgery, hospitalization charges, length of stay, and complications/adverse events.

Results: A total of 71,520 hospitalizations had a cleft lip and/or cleft palate repair / revisions performed in the entire United States during the years 2000 through 2008. Repair of cleft lip as a standalone procedure was done in 26% and as a concurrent procedure along with cleft palate repair/revision in 11% of hospitalizations. The mean age per hospitalization was 3.6 years. Males accounted for 57.3% of hospitalizations. Among hospitalizations for which race information was available, Whites accounted for 55.8% of procedures while blacks, Hispanics, Asian/Pacific islanders, Native Americans, and Other Races accounted for 5.7%, 24.2%, 6.1%, 1%, and 7.2% respectively.  The average length of stay in hospital was 2 days. The mean charge per each hospitalization ranged from $10,036 in the year 2000 through $23,603 in the year 2008. The primary payers included Medicare (0.2% of hospitalizations), Medicaid (40.4%), Private insurance plans (52.4%), and other insurance plans (5.5%). About 1.5% were uninsured. Close to 87% of all procedures were performed in teaching hospitals. Hospitals located in urban locations accounted for 98.6% of all procedures.

Conclusions: The current study results provide insights into nationally representative estimates on management of cleft lip/ palate repairs and revisions in the United States during the past decade.