Abstract：
UNASSIGNED: Accessing treatment at ACPA (American Cleft Palate-Craniofacial Association)-approved centers is challenging for individuals in rural communities. This study aims to assess how pediatric plastic surgery outreach clinics impact access for patients with orofacial cleft and craniosynostosis in Mississippi. An isochrone map was used to determine mean travel times from Mississippi counties to the sole pediatric hospital and the only ACPA-approved team in the state. This analysis was done before and after the establishment of two outreach clinics to assess differences in travel times and cost of travel to specialized plastic surgery care. Two sample t-tests were used for analysis.The addition of outreach clinics in North and South Mississippi led to a significant reduction in mean travel times for patients with cleft and craniofacial diagnoses across the state\'s counties (1.81 hours vs 1.46 hours, P < 0.001). Noteworthy travel cost savings were observed after the introduction of outreach clinics when considering both the pandemic gas prices ($15.27 vs $9.80, P < 0.001) and post-pandemic prices ($36.52 vs $23.43, P < 0.001).The addition of outreach clinics in Mississippi has expanded access to specialized healthcare for patients with cleft and craniofacial differences resulting in reduced travel time and cost savings for these patients. Establishing specialty outreach clinics in other rural states across the United States may contribute significantly to reducing burden of care for patients with clefts and craniofacial differences. Future studies can further investigate whether the inclusion of outreach clinics improves follow-up rates and surgical outcomes for these patients.
摘要：
■在ACPA（美国腭裂-颅面协会）批准的中心接受治疗对农村社区的个人来说是具有挑战性的。这项研究旨在评估密西西比州的儿科整形外科外展诊所如何影响口面裂和颅骨融合症患者的就诊。等时线图用于确定从密西西比州县到唯一的儿科医院和该州唯一的ACPA批准团队的平均旅行时间。这项分析是在建立两个外展诊所之前和之后进行的，以评估旅行时间和旅行费用的差异专业整形外科护理。使用两个样本t检验进行分析。北密西西比州和南密西西比州的外展诊所的增加导致该州各县的裂痕和颅面诊断患者的平均旅行时间显着减少（1.81小时vs1.46小时，P<0.001)。在引入外展诊所后，在考虑大流行天然气价格(15.27美元对9.80美元，P<0.001)和大流行后价格(36.52美元对23.43美元，P<0.001)时，观察到值得注意的旅行费用节省。密西西比州的外展诊所的增加扩大了对患有left裂和颅面差异的患者的专业医疗保健的访问，从而减少了这些患者的旅行时间并节省了成本。在美国其他农村州建立专业外展诊所可能会大大有助于减轻裂痕和颅面差异患者的护理负担。未来的研究可以进一步调查外展诊所的纳入是否可以改善这些患者的随访率和手术结果。
