National Assessment of Socioeconomic Disparity in Craniosynostosis.

Document Type

Conference Proceeding

Publication Date

9-2026

Publication Title

Plastic and Reconstructive Surgery. Global Open

Abstract

Objective: To evaluate socioeconomic factors in CS and their association with inpatient outcomes, including length of stay (LOS), complication, and hospitalization costs.

Methods: A retrospective cohort study of 9,028 CS inpatient admissions from Kids’ Impatient Database (KID) 2012-2022 was performed. CS admissions were identified by a primary diagnosis of ICD-9-CM code (756.0) or ICD-10-CM codes (Q75.00-75.09) with a corresponding CS-related primary procedure, identified as ICD-9-PCS codes 02.01, 02.03-02.06, or ICD-10-PCS codes such as 0NQ00ZZ. Outcomes of interest include race, insurance type, hospital charges, LOS, and complications (defined as CS-related re-operation, LOS >75th percentile, or mortality). Descriptive statistics summarized the cohort. Non-parametric and categorical univariate analyses assessed associations between socioeconomic differences and admission outcomes. Continuous variables are non-normal and presented as median [interquartile range].

Results: The median age at admission was < 1 year old [0-1]. Most patients were male (65.9%), non-Hispanic White (60.8%), and insured by private plans (49.3%) or Medicaid (43%). Median LOS was 3 days [2-4], and median hospital charge was $84,660 [$53,670-131,802]. Overall complication rate was 29.8%, including a re-operation rate of 18.6% and mortality of 0.03%.

Race was significantly associated with total hospital charges, LOS, and complications (all p< .001). White patients had the lowest median costs, with pairwise testing demonstrating statistically lower costs for White patients compared to Black, Asian, Hispanic and Other races (all p< .005). Black patients had the longest LOS (4 days [3,5]) and higher complication rates compared to White and Hispanic patients (both p< .001)

Privately insured patients had lower complication rates, lower hospital charges, and higher LOS compared to all other pay structures (all p < .0001). Lower patient household income quartile was associated with a higher LOS, re-operation, and complication (p< .001, p=0.0442, and p< .001).

Conclusion: Socioeconomic disparities exist in CS care at a national level. Race, insurance status, and income are associated with differences in LOS, complications, and hospital charges. These findings suggest that standardized treatment protocols fall short in the face of the social determinants of health, underscoring the need for targeted strategies to enhance outcomes for the most vulnerable patients with CS.

Volume

14

Issue

Suppl 4

First Page

2

Last Page

2

Comments

Michigan Academy of Plastic Surgeons 34th Biennial Scientific Meeting, July 12-15, 2026, Mackinac Island, MI

Helen DeVos Children's Hospital

DOI

10.1097/01.GOX.0001276664.81865.33

ISSN

2169-7574

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