Care Barriers for Patients With Nonsyndromic Orofacial Clefts in Saudi Arabia: A Cross-Sectional Study

Abstract

Objective: To evaluate the barriers faced by patients with nonsyndromic orofacial clefts (NSOFC) throughout their treatment course in Saudi Arabia. Design: A cross-sectional study. Setting: Eleven different governmental health care centers across Saudi Arabia. Patients: Records of pediatric patients with NSOFC. Interventions: A questionnaire with multiple validation stages was designed to assess the barriers in care of these patients through telephonic interviews with the parents or guardians of patients with NSOFC. Main Outcome Measures: We identified 3 care-barrier–related factors: (1) geographic accessibility, (2) appointment availability and accessibility, and (3) scheduling-related barriers. Results: Overall, 240 participants of both sexes, with orofacial cleft of various types and with various demographic characteristics (residence, family monthly income, and caregiver level of education) were included. The highest mean score of care barriers was reported for scheduling-related barriers. Overall, 186 individuals reported sometimes/often not receiving the required medical care for the following reasons: scheduling difficulties (89%; 37.1%), prolonged waiting room time (40%; 16.7%), and transportation difficulties (36%; 15.0%). A linear regression showed that parents cited late appointments as the main reason for patients with NSOFC not receiving adequate medical care. Care-barrier factors were significantly related to gender ( P = .035), patient age ( P < .001), place of residency ( P < .001), and caregiver’s level of education ( P = .015). Conclusions: Gaps in the health care system directly related to common care barriers need to be addressed to ensure adequate care for patients with NSOFC.

Risk Factors Associated with Children Receiving Treatment at Emergency Dental Clinics: A Case-Control Study

“…In this context, the parents of the ER-C group reported that the greatest care barriers were related to appointment availability, accessibility, and scheduling. This supports the findings of Allaf et al [17], who reported that, according to parents, schedule-related issues were the most common care barriers for their children. After adjusting the OR and overcoming the effects of confounding factors via the binary regression analysis, it was noted that participants in the ER-C group had primarily sought care in that location due to dental care barriers.…”

“…Dental Care Barriers, which is a validated questionnaire consisting of 10 items that are designed to assess relevant factors, including geographic accessibility, schedulingrelated barriers, and appointment availability and accessibility [17]. Total scores are calculated to reflect the overall degree of barriers, ranging from 10 (no barriers) to 46 (great barriers).…”

Oral Health Needs and Barriers among Children in Saudi Arabia

“…Moreover, although not significant, the AOR was increased in the northern region with a smaller population size than that of the central region, which includes the capital city and a larger population size [ 27 ]. This was also supported by a previous study conducted to assess the accessibility of medical care in children reporting more barriers for parents in rural areas than for parents in urban areas [ 28 ].…”

“…Furthermore, this study considered the different regions of Saudi Arabia, and the different regions comprised different population sizes, with the western and central regions covering the highest population frequency (more than 75% of the Saudi population) [ 27 ]. This was suggested to affect the accessibility, demand for, and burden of oral health care among the different regions [ 28 , 29 ]. In addition, the burden on parents included more difficult transportation and diverse life style in metropolitan cities compared with small cities [ 30 , 31 ].…”

“…As children grow older, their odds of complaining about the need of a dental visit increase because they are more capable of communicating and expressing their requirements and needs verbally and have demands for dental care that go beyond caries treatment and prevention [ 32 ]. However, the decreased odd ratio for dental barriers for younger children could also be attributed to the better accessibility and appointment availability for younger children in the health care system reported by parents in a previous study conducted on medical health care barriers [ 28 ].…”