Healthcare Trajectories of Adolescent Patients With Cleft Lip and/or Palate According to Health Insurance Coverage in Medellin, Colombia

<i>Objective</i>To describe and compare the healthcare trajectories of patients with CL/P under two different income-based programs for health coverage in Colombia, known in Colombia as a health insurance regime (contributory and subsidized), in Medellín, 2021.<i>Design</i>Non-experimental, cross-sectional questionnaire-based study.<i>Setting</i>Primary level of clinical care in Medellín, Colombia.<i>Participants</i>Twenty-eight 15- to 21-year-olds with CL/P and primary caregivers.<i>Interventions</i>Individuals with CL/P answered the survey. Patients with syndromic CL/P and patients with cognitive disabilities were excluded. The calculation of the probabilistic sample was performed based on the formula for finite populations using databases from 2 health insurance companies. The analysis was descriptive and bivariate. Chi-square and Fisher tests were used to analyze the variables of interest.<i>Main Outcome Measure</i>Continuity of the care pathway was measured with proxy indicators: (1) access to comprehensive CL/P treatment; (2) timeliness of access to comprehensive CL/P treatment; (3) differences in access to and timeliness of comprehensive CL/P treatment between patients under both health insurance coverage.<i>Results</i>No differences were found when comparing the healthcare trajectories of young patients with CL/P who were in both health coverage. Differences were observed in the timeliness of care for patients with CL/P under the subsidized coverage who were more economically vulnerable. Delays in care were mainly linked to administrative procedures required for orthodontic procedures, bone grafts, and maxillofacial surgeries.<i>Conclusion</i>Despite the health system's guarantee of equal care across income levels, differences in the timeliness of care persist for patients from lower-income families.