{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:05:02Z","timestamp":1790251502892,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Craniosynostosis, the premature fusion of calvarial bones, requires surgical intervention within a critical time\u2010period. Early referral potentiates the application of less invasive treatments. Previous studies from the United States have demonstrated that socioeconomically disadvantaged groups experience delayed referrals, older age at surgery and require more complex interventions. This study investigated the relationship between socioeconomic status and management for non\u2010syndromic single suture craniosynostosis within Australia's universal healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was completed at an Australian craniofacial centre from 2018 to 2024. Independent variables (Index of Relative Socioeconomic Advantage and Disadvantage score, rurality, sex, interpreter use) and outcomes (age at referral\/surgery, time between referral and appointment, procedure type, complications, and length of stay) were analysed with univariate and multivariate models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Totally, 200 patients were included. Age at referral and surgery were negatively correlated with Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) percentile. Multiple linear regression models demonstrated that for each one\u2010unit increase in the IRSAD decile, age at referral decreased by 24.26\u2009days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and age at surgery decreased by 23.29\u2009days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). No other factors were found to affect age at referral or age at surgery, and there were no differences in type of surgery, complications or length of stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study found that patients from socioeconomically advantaged backgrounds were referred earlier and underwent surgery at a younger age compared to disadvantaged counterparts. However, patients underwent the same surgical procedures, indicating that in Australia's universal healthcare setting, patients are falling within the critical window for intervention regardless of socioeconomic status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70751","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:49:16Z","timestamp":1779688156000},"page":"2416-2423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Socioeconomic Disadvantage Delay Access to Care for\u00a0Craniosynostosis? A Study of 200 Children in Australia's Universal Healthcare Context"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1119-3269","authenticated-orcid":false,"given":"Ishaan","family":"Thakur","sequence":"first","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinesh","family":"Chelliah","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery The Children's Hospital at Westmead  Sydney Australia"},{"name":"The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ur\u0161ka","family":"\u010cebron","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Aggarwala","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Olsson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery The Children's Hospital at Westmead  Sydney Australia"},{"name":"Division of Plastic and Reconstructive Surgery, the Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Marucci","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery The Children's Hospital at Westmead  Sydney Australia"},{"name":"The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549141291S206"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004787"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.7.PEDS18585"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"21","article-title":"Spring\u2010Assisted Cranioplasty for Isolated Sagittal Craniosynostosis: A Retrospective Review","volume":"8","author":"Lim J. L.","year":"2025","journal-title":"Australian Journal of Plastic Surgery"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006152"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000008815"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003519"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000008100"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.02.007"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000010162"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000008405"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.PEDS14342"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-011-1660-1"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000511"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000002725"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001238"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3171\/2021"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003765"},{"key":"e_1_2_10_20_1","volume-title":"Medicare","author":"Department of Health and Aged Care","year":"2024"},{"key":"e_1_2_10_21_1","volume-title":"Modified Monash Model","author":"Department of Health and Aged Care","year":"2024"},{"key":"e_1_2_10_22_1","volume-title":"Socio\u2010Economic Indexes for Areas (SEIFA), Australia [Internet]","author":"Autralian Bureau of Statistics","year":"2023"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000056839.94034.47"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182412a50"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2015.12.007"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0377"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1302\/1863-2548.11.160228"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12475"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13436"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15197"},{"key":"e_1_2_10_31_1","unstructured":"E.Scott \u201cBulk Billing Rates Across Australia\u2010and Where You're Most Likely to Find a Fee\u2010Free GP \u201d SBS News 2025 accessed January 17 2025 https:\/\/www.sbs.com.au\/news\/article\/bulk-billing-rates-across-australia-and-where-youre-most-likely-to-find-a-fee-free-gp\/mdunrqyoc."},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-015-3279-z"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817725695"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70751","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70751","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:17:24Z","timestamp":1790248644000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,24]]},"references-count":32,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/ans.70751"],"URL":"https:\/\/doi.org\/10.1111\/ans.70751","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,24]]},"assertion":[{"value":"2026-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}