Characteristics of dysplastic acetabulum in neurogenic hip disease with three‐dimensional computer evaluation

Background and Objective(s): Minnesota has a population of 5.6 million people, approximately 40% living outside the major metropolitan & urban areas. This more rural population is diverse, multinational with a large proportion of people having Native American heritage. Extreme weather conditions, isolated wilderness communities and excessive alcohol & drug abuse are only some of the barriers these families must surmount. In this context an outreach program to service their specialty healthcare developmental needs was created 30 years ago. Study Design: Continuous Qualitative Population based study. Study Participants & Setting: A large population of adults & children requiring specialty healthcare in northern Minnesota. 2675 average patient visits/year, 66% having cerebral palsy, 14% TBI and less than 10% spina bifida, genetic syndromes, fetal alcohol effect & other conditions of a developmental nature. 62% children, 56% male with an average age of 13.6 years. Materials/Methods: Periodic, survey analysis. On an annual basis, every patient is given a survey to complete regarding qualitative aspects of their rural specialty healthcare. The survey was created by the multidisciplinary outreach rehabilitation team in collaboration with parent and family feedback as part of the Gillette Specialty Healthcare internal quality assurance process. Approximately 59% of the surveys were completed by a competent family member, 28% a professional careprovider & 13% by the patient. An average of 586 surveys were handed out per year with a return rate of approximately 35% (204). Results: 86% reported improved access to medical specialty services & 78% to assistive technology. 71% would have driven over 100 miles per visit if local specialty healthcare were absent. 4.1 million miles of driving to medical appointments were saved ($2.3 million dollars @ 0.56 cents per mile) by patients & families over the past decade. Improvements in mobility (71%), general well being (67%), comfort (62%), family stress (61%), school attendance (60%) & ability to take a vacation (29%) were all noted. Economic benefit were reported in saved wages (46%), with savings in lodging & meal costs, 41% & 72% respectively. Conclusions/Significance: Gillette Specialty Medical Services of Greater Minnesota has facilitated improvements in rural healthcare & technology access along with dollars saved, school attendance & other qualitative life experiences as reported by sizeable majorities of patients & families with developmental needs. Other tertiary care institutions need to consider the Gillette Model in service to this often neglected rural population of children & adults with conditions of childhood onset. SP 35 Characteristics of dysplastic acetabulum in neurogenic hip disease with three-dimensional computer evaluation M JOZWIAK, B MUSIELAK, M RYCHLIK, B CHEN Pediatric Orthopaedics and Traumatology Department, Dega Hospital, Poznan University of Medical Sceinces, Poznan, Poland; Poznan University of Technology, Poznan, Poland; Nemours/Alfred I. duPont Hospital for Children, Department of Orthopedic Surgery, Willmington, DE, USA