A research team investigated the socioeconomic disparities in access to care for cranial remolding orthoses (CRO) for correction of deformational plagiocephaly. They found that lower-income and Medicaid-insured patients had delayed presentation for CRO consultation, and that patients from the lowest income quartile were more likely to never receive a CRO than those from wealthier backgrounds.
To complete the study, researchers collected demographic data through a retrospective review of medical records from a single CRO company in Connecticut from 2014 to 2020, and univariable logistic regressions were used to identify differences for presenting age at consultation, whether CRO was pursued, and length of CRO treatment by insurance payor and household income quartile.
Of the 5,620 patients identified, 4,100 (73 percent) received a CRO, and 674 (12 percent) receiving a second helmet. Of those receiving a CRO, 1,536 (37.5 percent) had Medicaid insurance, and 2,558 (62.4 percent) were commercially insured. Patients on Medicaid were 1.30 times more likely to have delayed presentation, while patients from the lowest income quartile were 1.26, 1.50, and 1.58 times more likely to have a delayed presentation relative to those in the highest and second-highest income quartiles, respectively.
Patients in the highest and second-highest income quartiles were also 1.55 and 1.45 more likely, respectively, to receive a CRO after consultation than those from the lowest income quartile.
The article, “Disparities in Access to Cranial Remodeling Orthosis for Deformational Plagiocephaly,” was published in the Cleft Palate-Craniofacial Journal.
