Abstract
BackgroundA child born with an orofacial cleft will require long-term multidisciplinary treatment from birth through to adulthood. In the United Kingdom (UK) this treatment is funded by the National Health Service (NHS) and provided at hub and hub and spoke centres. There is currently very limited information on the cost of cleft care on the direct and indirect costs to the parent and child in the UK.
Aims
To identify and compare the direct and indirect costs to the parent and child born with orofacial cleft from birth to 20 years of age in the UK. To compare the costs incurred between hub only and hub and spoke patients.
Methods
This was a 2-part study, using qualitative data collection and analysis through focus groups, followed by quantitative data collection and analysis through the national distribution of an online questionnaire.
Results
The largest direct costs incurred were childcare, private care, and costs associated with attending outpatient appointments. Virtual appointment costs were considerably less than outpatient or inpatient appointment costs. The largest indirect cost incurred related to a parent taking time out of work for their child’s cleft care. The costs appear to be greatest in the first 7 years and reduce with increasing age to adulthood. There was a statistically significant lower travel cost for families attending hub and spoke sites, compared to those attending hub only sites. There were no other statistically significant differences in costs incurred between hub only and hub and spoke patients across all other cost categories.
Conclusion
Families incur significant direct and indirect costs for cleft care from birth through to adulthood. The largest costs were time out of work, childcare, outpatient appointments and private care. Travel costs for patients attending hub and spoke sites are lower than for those attending hub only sites.
| Date of Award | 23 Jan 2024 |
|---|---|
| Original language | English |
| Awarding Institution |
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| Supervisor | Julie C Williams (Supervisor), Peter V Fowler (Supervisor), Joanna C Thorn (Supervisor) & Samantha K Husbands (Supervisor) |