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The Impact of Socioeconomic and Geographical Risk Factors on Health Outcomes in Children with Craniosynostosis in West Virginia
Jessica L. Biagiotti, BS
Aaron C. Mason, MD
West Virginia University
2019-02-15
Presenter: Jessica Biagiotti
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. This project represents the original work of Jessica Biagiotti.
Director Name: Aaron Mason MD FAACS FAP
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction
Surgical intervention for craniosynostosis is typically done before 1 year of age. Lack of early evaluation and correction can lead to a variety of craniofacial deformities and neurological sequelae, specifically neurodevelopmental impairment. Barriers to healthcare in vulnerable populations, such as Appalachia, may lead to delayed diagnoses and definitive surgical treatment, which in turn can negatively impact clinical outcomes. The goal of this study is to identify and assess the impact of unique socioeconomic and geographical determinants of health afflicting children receiving care for craniosynostosis in West Virginia.
Methods
We conducted a retrospective chart review and telephone questionnaire on the 41 patients that underwent evaluation and treatment for craniosynostosis at the WVU Medicine Children's Craniofacial Center. Predictor variables included distance to WVU, HPSA county designation, and insurance type. The outcome variable was age at surgical intervention. Open ended questions were asked to allow for qualitative perspectives on care access.
Results
Initial results reveal children with private insurance were on average 141 days old at the time of surgery; children with public insurance were 209.5 days. Patients traveling a distance < 60 miles were 151.61 days; > 60 miles were 219.37 days. Only 1 patient was not in a total or partial HPSA county.
Conclusion
Patients with a long travel distance and public insurance are more likely to receive surgery at an older age in West Virginia. Examination and identification of barriers can be used to improve timeliness and access to care in order to maximize chances for positive health outcomes.
