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Long-term effects of oral clefts on health care utilization: a sibling comparison

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Abstract

Oral clefts are among the most common birth defects affecting thousands of newborns each year, but little is known about their potential long-term consequences. In this paper, we explore the impact of oral clefts on health care utilization over most of the lifespan. To account for time-invariant unobservable parental characteristics, we compare affected individuals with their own unaffected siblings. The analysis is based on unique data comprising the entire cohort of individuals born with oral clefts in Denmark tracked until adulthood in administrative register data. We find that children with oral clefts use more health services than their unaffected siblings. Additional results show that the effects are driven primarily by congenital malformation-related hospitalizations and intake of anti-infectives. Although the absolute differences in most health care utilization diminish over time, affected individuals have slightly higher utilization of some health care services in adulthood (particularly for diseases of the nervous and respiratory system). These results have important implications for affected individuals, their families, and their health professionals.

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Notes

  1. Some medical drugs are not assigned a specific DDD value. Hence, this measure of medical drug intake is limited in the way that it is only possible to measure medical drug intake for drugs with an assigned DDD value.

  2. We do not consider dental care as an outcome because most dental treatments for individuals with oral clefts are delivered at oral cleft centers, which are not reported in the Danish National Health Service Register.

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Acknowledgments

The authors would like to thank two anonymous referees for helpful comments. The study was supported by the Centers for Disease Control and Prevention (CDC) grant 1R01DD000295. The contents of this work are the sole responsibility of the authors and do not necessarily represent the official views of the CDC.

Conflicts of interest

The authors have no conflicts of interest in this work.

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Authors and Affiliations

  1. Department of Business and Economics, Centre of Health Economics Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark

    Morten Saaby Pedersen

  2. Department of Economics, Centre for Economic and Business Research, Copenhagen Business School, Porcelænshaven 16A, 2000, Frederiksberg, Denmark

    Morten Saaby Pedersen

  3. Department of Health Management and Policy, University of Iowa, Iowa City, IA, USA

    George L. Wehby

  4. National Bureau of Economic Research, Cambridge, MA, USA

    George L. Wehby

  5. Department of Epidemiology, Biostatistics and Biodemography, Institute for Public Health, University of Southern Denmark, J.B. Winsløvsvej 9B, 5000, Odense C, Denmark

    Dorthe Almind Pedersen & Kaare Christensen

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  1. Morten Saaby Pedersen
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  2. George L. Wehby
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Correspondence to Morten Saaby Pedersen or George L. Wehby.

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Pedersen, M.S., Wehby, G.L., Pedersen, D.A. et al. Long-term effects of oral clefts on health care utilization: a sibling comparison. Eur J Health Econ 16, 603–612 (2015). https://doi.org/10.1007/s10198-014-0612-6

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  • DOI: https://doi.org/10.1007/s10198-014-0612-6

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