Connor S Wagner, Sarah L Barnett, Dominic Romeo, Carrie Z Morales, Lauren K Salinero, Carlos E Barrero, Matthew E Pontell, Rachel A McKenna, Nancy Folsom, Jesse A Taylor, Jordan W Swanson
{"title":"社会人口因素可预测多学科裂隙诊所的长期流失率。","authors":"Connor S Wagner, Sarah L Barnett, Dominic Romeo, Carrie Z Morales, Lauren K Salinero, Carlos E Barrero, Matthew E Pontell, Rachel A McKenna, Nancy Folsom, Jesse A Taylor, Jordan W Swanson","doi":"10.1177/10556656241234804","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveIdentify and describe factors associated with retention and attrition of patients during longitudinal follow-up at multidisciplinary cleft clinic.DesignRetrospective cohort study.SettingSingle, tertiary care center.Patients, ParticipantsPatients born between 1995 and 2007 with a diagnosis of cleft palate with or without cleft lip attending multidisciplinary cleft clinic.InterventionsNone tested, observational study.Main Outcome Measure(s)Age at last clinical appointment with a multidisciplinary cleft team provider. Attrition was defined as absence of an outpatient appointment following 15 years of age.ResultsSix hundred seventy-eight patients were included. The average age at last appointment across the entire cohort was 13.1 years (IQR 6.6-17.2). Patients who were Black (HR 1.60, 95% CI 1.10-2.32, p = 0.014) and other races (HR 1.90, 95% CI 1.22-2.98, p = 0.004) were more likely to be lost to follow-up compared to white patients. Publicly insured patients were more likely to experience attrition than those who were privately insured (HR 1.30, 95% CI 1.03-1.65, p = 0.030). Estimated income was not significantly associated with length of follow-up (p = 0.259). Those whose residence was in the fourth quartile of driving distance from our center experienced loss to follow-up significantly more than those who lived the closest (HR 2.04, 95% CI 1.50-2.78, p < 0.001).ConclusionsThere is a high degree of follow-up attrition among patients with cleft lip and palate. Race, insurance status, and driving distance to our center were associated with attrition in a large, retrospective cohort of patients who have reached the age of cleft clinic graduation.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1003-1010"},"PeriodicalIF":1.1000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sociodemographic Factors Predict Long-Term Attrition from Multidisciplinary Cleft Clinic.\",\"authors\":\"Connor S Wagner, Sarah L Barnett, Dominic Romeo, Carrie Z Morales, Lauren K Salinero, Carlos E Barrero, Matthew E Pontell, Rachel A McKenna, Nancy Folsom, Jesse A Taylor, Jordan W Swanson\",\"doi\":\"10.1177/10556656241234804\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>ObjectiveIdentify and describe factors associated with retention and attrition of patients during longitudinal follow-up at multidisciplinary cleft clinic.DesignRetrospective cohort study.SettingSingle, tertiary care center.Patients, ParticipantsPatients born between 1995 and 2007 with a diagnosis of cleft palate with or without cleft lip attending multidisciplinary cleft clinic.InterventionsNone tested, observational study.Main Outcome Measure(s)Age at last clinical appointment with a multidisciplinary cleft team provider. Attrition was defined as absence of an outpatient appointment following 15 years of age.ResultsSix hundred seventy-eight patients were included. The average age at last appointment across the entire cohort was 13.1 years (IQR 6.6-17.2). Patients who were Black (HR 1.60, 95% CI 1.10-2.32, p = 0.014) and other races (HR 1.90, 95% CI 1.22-2.98, p = 0.004) were more likely to be lost to follow-up compared to white patients. Publicly insured patients were more likely to experience attrition than those who were privately insured (HR 1.30, 95% CI 1.03-1.65, p = 0.030). Estimated income was not significantly associated with length of follow-up (p = 0.259). Those whose residence was in the fourth quartile of driving distance from our center experienced loss to follow-up significantly more than those who lived the closest (HR 2.04, 95% CI 1.50-2.78, p < 0.001).ConclusionsThere is a high degree of follow-up attrition among patients with cleft lip and palate. Race, insurance status, and driving distance to our center were associated with attrition in a large, retrospective cohort of patients who have reached the age of cleft clinic graduation.</p>\",\"PeriodicalId\":49220,\"journal\":{\"name\":\"Cleft Palate-Craniofacial Journal\",\"volume\":\" \",\"pages\":\"1003-1010\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cleft Palate-Craniofacial Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10556656241234804\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"Dentistry\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cleft Palate-Craniofacial Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10556656241234804","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Dentistry","Score":null,"Total":0}
引用次数: 0
摘要
目标:确定并描述多学科裂隙诊所纵向随访期间患者保留和流失的相关因素:确定并描述多学科唇裂诊所纵向随访期间患者保留和流失的相关因素:设计:回顾性队列研究:单一三级医疗中心:干预措施:无试验,观察性研究:无试验,观察性研究:主要结果测量指标:最后一次与多学科唇裂团队提供者进行临床预约时的年龄。自然减员的定义是 15 岁后未接受门诊预约:结果:共纳入 678 名患者。所有患者最后一次就诊的平均年龄为 13.1 岁(IQR 6.6-17.2)。与白人患者相比,黑人患者(HR 1.60,95% CI 1.10-2.32,p = 0.014)和其他种族患者(HR 1.90,95% CI 1.22-2.98,p = 0.004)更容易失去随访机会。公共保险患者比私人保险患者更容易流失(HR 1.30,95% CI 1.03-1.65,p = 0.030)。估计收入与随访时间没有明显关系(p = 0.259)。居住地与我们中心的车程距离处于第四四分位数的患者的随访损失明显高于居住地最近的患者(HR 2.04,95% CI 1.50-2.78,p 结论:我们中心的随访损失较高:唇腭裂患者的随访流失率很高。在一个大型的回顾性队列中,达到唇腭裂诊所毕业年龄的患者的种族、保险状况和到我们中心的驾车距离与流失有关。
Sociodemographic Factors Predict Long-Term Attrition from Multidisciplinary Cleft Clinic.
ObjectiveIdentify and describe factors associated with retention and attrition of patients during longitudinal follow-up at multidisciplinary cleft clinic.DesignRetrospective cohort study.SettingSingle, tertiary care center.Patients, ParticipantsPatients born between 1995 and 2007 with a diagnosis of cleft palate with or without cleft lip attending multidisciplinary cleft clinic.InterventionsNone tested, observational study.Main Outcome Measure(s)Age at last clinical appointment with a multidisciplinary cleft team provider. Attrition was defined as absence of an outpatient appointment following 15 years of age.ResultsSix hundred seventy-eight patients were included. The average age at last appointment across the entire cohort was 13.1 years (IQR 6.6-17.2). Patients who were Black (HR 1.60, 95% CI 1.10-2.32, p = 0.014) and other races (HR 1.90, 95% CI 1.22-2.98, p = 0.004) were more likely to be lost to follow-up compared to white patients. Publicly insured patients were more likely to experience attrition than those who were privately insured (HR 1.30, 95% CI 1.03-1.65, p = 0.030). Estimated income was not significantly associated with length of follow-up (p = 0.259). Those whose residence was in the fourth quartile of driving distance from our center experienced loss to follow-up significantly more than those who lived the closest (HR 2.04, 95% CI 1.50-2.78, p < 0.001).ConclusionsThere is a high degree of follow-up attrition among patients with cleft lip and palate. Race, insurance status, and driving distance to our center were associated with attrition in a large, retrospective cohort of patients who have reached the age of cleft clinic graduation.
期刊介绍:
The Cleft Palate-Craniofacial Journal (CPCJ) is the premiere peer-reviewed, interdisciplinary, international journal dedicated to current research on etiology, prevention, diagnosis, and treatment in all areas pertaining to craniofacial anomalies. CPCJ reports on basic science and clinical research aimed at better elucidating the pathogenesis, pathology, and optimal methods of treatment of cleft and craniofacial anomalies. The journal strives to foster communication and cooperation among professionals from all specialties.