{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:34:35Z","timestamp":1787697275689,"version":"build-2784847793"},"reference-count":25,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The primary aim was to assess the cost (\u00a3) to the National Health Service (NHS) of hospital treatment for individuals born with bilateral cleft lip and palate (BCLP), unilateral cleft lip and palate (UCLP), and cleft palate (CP), from birth to 20 years. The secondary aim was to assess the number of scheduled clinical outpatient and inpatient\/outpatient surgical visits for this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective micro-costing analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Patients treated within the South West of England Cleft Service (UK).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Twenty-three case-notes of children born with cleft (5 BCLP; 10 UCLP; 8 CP) were identified from birth up to and including secondary alveolar bone graft (ABG), and a second group of 23 hospital case-notes (3 BCLP; 10 UCLP; 10 CP) were identified, post-ABG to 20 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean costs from birth to ABG were \u00a317,004 (BCLP), \u00a311,620 (UCLP), and \u00a36137 (CP), and post-ABG to 20 years were \u00a39,463, \u00a37,945, and \u00a33,816, respectively. The largest costs were for staff. Repeat surgery had a significant impact on costs. The mean number of clinical outpatient visits for BCLP, UCLP, and CP were 140, 110 and 83 respectively and 8, 6 and 2 for inpatient\/outpatient surgical visits, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Costs for provision of cleft care by the NHS are significant. The greatest costs were incurred with care for patients with BCLP. Patients were expected to attend many appointments, with BCLP experiencing the most visits. Engagement with quality improvement programmes to minimise repeat surgery, and remote consultation for certain appointments, to reduce the patient burden are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656241289669","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T11:19:19Z","timestamp":1728991159000},"page":"2016-2025","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Hospital-based Costs to the National Health Service (UK) for Children and Adolescents Born with Cleft from Birth to 20 Years"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8215-6078","authenticated-orcid":false,"given":"Kyle","family":"Durman","sequence":"first","affiliation":[{"name":"University of Bristol"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleem","family":"Hasanally","sequence":"additional","affiliation":[{"name":"University of Bristol"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Thorn","sequence":"additional","affiliation":[{"name":"University of Bristol"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Ireland","sequence":"additional","affiliation":[{"name":"University of Bristol"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9441-7410","authenticated-orcid":false,"given":"Peter","family":"Fowler","sequence":"additional","affiliation":[{"name":"University of Bristol"},{"name":"Faculty of Dentistry, University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9333-7627","authenticated-orcid":false,"given":"Scott","family":"Deacon","sequence":"additional","affiliation":[{"name":"University of Bristol"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-9700","authenticated-orcid":false,"given":"Jonathan","family":"Sandy","sequence":"additional","affiliation":[{"name":"University of Bristol"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Cleft Lip and Palate Association. NHS Cleft Teams \u2013 Treatment; 2023. Accessed September 28 2023. https:\/\/www.clapa.com\/treatment\/nhs-cleft-teams\/."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ortho.25.1.21"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/ocr.12111"},{"key":"e_1_3_3_5_2","unstructured":"NHS England. NHS standard contract for cleft lip and \/ or palate services including non-cleft velopharyngeal dysfunction; 2013. Accessed September 28 2023. https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/06\/d07-cleft-lip.pdf."},{"key":"e_1_3_3_6_2","unstructured":"Cleft Registry and Audit Network. Our priorities; 2023. Accessed September 28 2023. https:\/\/www.crane-database.org.uk\/about\/priorities\/"},{"key":"e_1_3_3_7_2","unstructured":"Cleft Registry and Audit Network. About the Cleft Development Group; 2023. Accessed September 28 2023. https:\/\/www.crane-database.org.uk\/resources\/the-cleft-development-group\/"},{"key":"e_1_3_3_8_2","unstructured":"Robertson R Wenzel L Thompson J Charles A. Kings Fund - Understanding NHS financial pressures - how are they affecting patient care; 2017. Accessed September 28 2023. https:\/\/www.kingsfund.org.uk\/publications\/understanding-nhs-financial-pressures."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.79.929.147"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195108248.001.0001"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13561-020-0260-8"},{"key":"e_1_3_3_12_2","unstructured":"Souster GJC. Micro-costing analysis of costs to the National Health Service and to the family for a child born with unilateral cleft lip and palate: from immediately after birth to 5 years of age. DDS. University of Bristol; 2017."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-014-0610-8"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjl047"},{"issue":"5","key":"e_1_3_3_15_2","article-title":"Invited Sessions at ACPA's 80th Annual Meeting: Comparing surgical costs and risks of Traditional and Anatomic Cleft Restoration Philosophy-based repairs: framing the full cost & risk picture by evaluating direct surgical costs & number of surgeries required by completion of treatment at maturity","volume":"60","author":"Mann S","year":"2023","unstructured":"Mann S, Mann R. Invited Sessions at ACPA's 80th Annual Meeting: Comparing surgical costs and risks of Traditional and Anatomic Cleft Restoration Philosophy-based repairs: framing the full cost & risk picture by evaluating direct surgical costs & number of surgeries required by completion of treatment at maturity. 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