A Pandemic in Review: The Impact on Surgical Volume of Cleft Lip and Palate

Abstract

We seek to evaluate the financial impact of the COVID-19 pandemic on pediatric craniomaxillofacial surgeries for cleft lip and/or palate. These surgeries are carefully timed for optimal outcomes, but the pandemic necessitated postponement or cancellation of elective procedures. Our study quantifies the decline in cases and associated charges at a single academic medical center before and after the pandemic. After receiving Institutional Review Board approval, we analyzed the financial billing data of 83 patients who underwent cleft lip and/or palate repair at an academic medical center. The caseload and charges incurred in the year before the COVID-19 pandemic (March 2019 to February 2020) were compared to the 2 years following the pandemic’s onset (March 2020 to February 2022). Statistical analysis was conducted using paired t-tests and the Wilcoxon signed-rank. In the year following the onset of the pandemic, we observed a significant decrease in the number of cleft lip and/or palate repairs performed per month (from 2.75 to 1.42 per month, P-value .021) and a decrease in per-month charges for these procedures ($13 334.75 to $7237.17 per month, P-value .036). However, when examining data over the 2 years post-COVID, these differences no longer remain statistically significant ( P-value .25 for cases and P-value .32 for charges), indicating a return to pre-COVID baseline. There was a statistically significant decrease in cleft lip/palate repair surgeries in the 12 months following the start of the COVID-19 pandemic. Both the caseload and total charges decreased after March 2020, with a subsequent return to baseline after 2 years. These findings emphasize that the pandemic had a transient impact on pediatric craniomaxillofacial surgical volume at our institution. While acknowledging our study’s external validity, we advocate for a nuanced approach, with flexible staffing crucial in facilitating a swift return to normal elective volumes.