Health care expenditures among Medicaid enrolled children with and without orofacial clefts in North Carolina, 1995–2002

Abstract

Children with OFC have significantly higher health-related Medicaid expenditures than unaffected children. These findings are important for targeting care coordination and early intervention and for program planning and policy development related to special needs children.

Hospital use and associated costs of children aged zero‐to‐two years with craniofacial malformations in Massachusetts

“…The North Carolina analysis of linked birth defects surveillance and Medicaid data on infants reported an average payment for inpatient hospitalization during the first year of life during 1995-2002 of $11,591 for children with orofacial clefts overall, and $3097 for infants with isolated clefts and $27,549 for those with multiple anomalies including a cleft (Cassell et al, 2008). The mean hospital cost during the first two years of life for all 474 children with orofacial clefts in Massachusetts was $21,090, which appears consistent with the North Carolina estimates.…”

“…An important advantage of both the PELL study and the North Carolina study by Cassell et al (2008) is the use of state birth defects surveillance data for validated case ascertainment. This method of ascertainment also allowed the investigators to accurately distinguish different types of CFMs.…”

“…The present study differs in three ways from the two recent cost studies of orofacial clefts during infancy (Cassell et al, 2008;Boulet et al, 2009): 1) It includes other types of craniofacial malformations, 2) it includes all children in a geographically defined population regardless of health care payer type, and 3) it is restricted to hospitalizations during the first two years of life. Like the North Carolina study by Cassell et al, the present estimates apply to just one state.…”

“…Since then, two additional studies of costs for children with orofacial clefts using administrative data have been published. In North Carolina an analysis linked birth defects surveillance data to Medicaid records for 1995-2002 births with orofacial clefts and followed 595 children who remained enrolled in Medicaid, some through four years of age (Cassell et al, 2008). Like the present study, the North Carolina study estimated expenditures separately for infants with isolated clefts by type of cleft and those with multiple anomalies including a cleft (Cassell et al, 2008).…”

“…In North Carolina an analysis linked birth defects surveillance data to Medicaid records for 1995-2002 births with orofacial clefts and followed 595 children who remained enrolled in Medicaid, some through four years of age (Cassell et al, 2008). Like the present study, the North Carolina study estimated expenditures separately for infants with isolated clefts by type of cleft and those with multiple anomalies including a cleft (Cassell et al, 2008). Another study estimated health care expenditures recorded in a national, administrative insurance claims database for 81 children in a privately insured population who had a billing code for an orofacial cleft recorded in connection with a claim for reimbursement during 2004 (Boulet et al, 2009).…”