Abstract
Objective: 1) To estimate the current incidence of cleft lip in the United States and whether any regional variations exist. 2) To determine national variations in resource utilization in the primary repair of cleft lip and identify patient and institutional factors associated with increased resource use.
Method: Retrospective analysis of a national, pediatric database (2009 Kids Inpatient Database (KID)). Patients aged 1 year and below were selected using diagnoses codes for cleft lip and procedure codes for lip repair. A number of demographic variables were analyzed and hospital charges were considered as a measure of resource utilization.
Results: There were 1318 patients identified. Overall incidence nationwide was 0.09% with male to female ratio of 1.8:1. Regional incidence varied from 0.07% (Northeast) to 0.10% (West). The mean age at surgery was 4.2 months. The average length of stay was 1.4 days, with minimal regional variation. The average total charge nationwide was $20,147, ranging from $14,635 (South) to $23,663 (West). Average charge in a teaching institution was $9764 higher than for nonteaching institutions. The strongest predictor of charge was length of stay, increasing by $8102 for every additional hospital day (P < .01).
Conclusion: Regional variations exist in resource utilization for primary cleft lip repair. Resource use is higher in the West and among teaching institutions. These results show that whiles length of stay is a key determinant of charge; other factors also play a role.
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