Health care utilization and expenditures for privately and publicly insured children with sickle cell disease in the United States

Mvundura, Mercy; Amendah, Djesika D.; Kavanagh, Patricia L.; Sprinz, Philippa G.; Grosse, Scott D.

doi:10.1002/pbc.22069

Cited by 90 publications

(69 citation statements)

References 19 publications

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“…Although studies have shown that inpatient hospital, outpatient hospital, or emergency department visits did not differ significantly between a national sample of privately insured and Medicaidenrolled adults after controlling for health status and other factors [22], higher rates of health services utilization have been reported for Medicaid-enrolled children with SCD compared their privately insured counterparts [23]. We were also unable to identify the states from which the Medicaid sample was drawn and, therefore, could not assess the effects of regional variations in the management and treatment of SCD or pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

Boulet

Okoroh

Azonobi

et al. 2013

Matern Child Health J

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Higher frequencies of pregnancy complications have been reported among women with sickle cell disease (SCD) compared with those without SCD; however, past studies are limited by small sample size, narrow geographic area, and use of hospital discharge data. We compared the prevalence of maternal complications among intrapartum and postpartum women with SCD to those without SCD in a large, geographically diverse sample. Data from the 2004-2010 Truven Health MarketScan ® Multi-State Medicaid databases were used to assess the prevalence of maternal complications among intrapartum and postpartum women 15-44 years of age with and without SCD whose race was reported as black. The comparison group of women without SCD was further divided into those with chronic conditions associated with multi-organ failure and those without chronic conditions. Multivariable log-binomial regression models were used to calculate adjusted prevalence ratios for outcomes for women with SCD compared with women in the two comparison groups. Of the 335,348 black women with a delivery during 2004-2010, 1,526 had a diagnosis of SCD (0.5 %). Compared with women without SCD who had chronic conditions, women with SCD had higher prevalence of deep vein thrombosis, pulmonary HHS Public Access Author manuscriptMatern Child Health J. Author manuscript; available in PMC 2015 April 13. Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript embolism, obstetric shock, pneumonia, sepsis, postpartum infection, and transfusions. SCD was also positively associated with acute renal failure, cerebrovascular disorder, respiratory distress syndrome, eclampsia, postpartum hemorrhage, preterm birth, and ventilation when compared with women without SCD and chronic conditions. Overall, women with SCD have increased prevalence of pregnancy complications, even when compared with a group of women with similar risk for multi-organ failure.

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Section: Discussionmentioning

confidence: 99%

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

Boulet

Okoroh

Azonobi

et al. 2013

Matern Child Health J

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“…Sixty to eighty percent of pediatric SCD patients are publically insured; and, dependent upon the state in which they live, there is a high potential that they will age out of Medicaid at age 18. Thus, many patients are left with no health insurance or they remain publically insured at the time of transition (Debaun & Telfair, 2012;Mvundura, Amendah, Kavanagh, Sprinz, & Grosse, 2009). Both scenarios are associated with poor health outcomes, including higher ED wait times, higher rehospitalization rates, higher numbers of acute care encounters and lower likelihood of getting an appointment with a specialty care provider (Agency for Healthcare Research and Quality, 2011;Bisgaier & Rhodes, 2011;Brousseau, Owens, et al, 2010).…”

Section: Factors Influencing Transitionmentioning

confidence: 99%

Health Literacy in Adolescents With Sickle Cell Disease

Perry

Carter

Becker

et al. 2017

Journal of Pediatric Nursing

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“…Another study showed that 18-30-year-olds had the highest average annual ED utilization rates compared to other age groups [15]. Furthermore, studies have demonstrated a higher average number of ED visits for uninsured patients with SCD compared to those who are privately insured [6,15]. However, there is limited information available about the influence of socioeconomic status on the use of health care services amongst patients with SCD.…”

Section: Journal Of Hematology and Thromboembolic Diseasesmentioning

confidence: 97%

“…patients with SCD [6,[14][15][16][17]. Based on the Thomas Jefferson University Hospital data, Epstein et al found that women had fewer hospitals ED visits but the difference between male and female officebased visits was not statistically significant [14].…”

Section: Journal Of Hematology and Thromboembolic Diseasesmentioning

confidence: 99%

“…Patients with SCD have an increased risk of developing sickle-shaped red blood cells that occlude small vessels which can affect every major organ and gives rise to a severe acute pain termed a 'crisis' [3]. Crises are the most frequent cause of hospital ED visits in this patient population [4][5][6]. Other clinical manifestations of sickle cell disease include anemia, increased susceptibility to infections, acute chest syndrome, neurologic complications such as cerebral infarction and hemorrhage, avascular necrosis of the femoral and humeral heads, retinal detachment, pulmonary hypertension and heart disease [7].…”

Section: Introductionmentioning

confidence: 99%

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Factors that Predict Outpatient Department Utilization amongst Sickle Cell Disease Patients in the USA

Lanzkron¹,

Bollinger²

2017

J Hematol Thrombo Dis

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Individuals with sickle cell disease (SCD) frequently present in the emergency room due to various complications that may arise from their condition. Optimal healthcare for people with SCD utilizes outpatient department (OPD) diagnostic and preventive care services. This paper investigates the factors associated with OPD visits compared to Emergency department (ED) visits in patients with SCD. SCD-related OPD visits and ED visits were obtained from the openly available National Hospital Ambulatory Medical Care Survey (NHAMCS) and National Ambulatory Medical Care Survey (NAMCS) data for the years 2009-2010. A total of 822,353 weighted visits by people with SCD were analyzed. Descriptive data include patient demographics, geographical location, and socioeconomic status associated with hospital OPD visits. Of the 812,366 weighted visits, 361,024 were made to the ED and 451,342 were made to the OPD. The median predicted probability of using the OPD amongst patients with SCD was 50%. We found that patients with SCD who had a below median probability of using OPD services were mostly female (66.12%), African-American (98.35%), Medicaid-insured (61.98%) and between the ages of 20-30 years old (42.98%). Individuals with SCD residing in neighborhoods with average income below $52,000 (96.69%), more than 10% below poverty level (86.55%) and less than 20% with a bachelor degree or higher (63.87%) made up the majority of people with below median probability of making OPD visits. This study suggests that there are sociodemographic differences in the utilization of outpatient services amongst people with SCD. Efforts at improving OPD use amongst patients with sickle cell disease should target these patients.

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Health care utilization and expenditures for privately and publicly insured children with sickle cell disease in the United States

Cited by 90 publications

References 19 publications

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

Health Literacy in Adolescents With Sickle Cell Disease

Factors that Predict Outpatient Department Utilization amongst Sickle Cell Disease Patients in the USA

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