Medical care utilization and mortality in sickle cell disease: A population‐based study

The purpose of this study was to evaluate the pattern of medical care utilization and mortality in children and adults with sickle cell disease (SCD) in the state of Tennessee. Rates of hospitalization, emergency department visits, and deaths were measured in a cohort of adults and children with SCD...

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Bibliographic Details
Published in:American journal of hematology 2005-12, Vol.80 (4), p.262-270
Main Authors: Shankar, Sadhna M., Arbogast, Patrick G., Mitchel, Ed, Cooper, William O., Wang, Winfred C., Griffin, Marie R.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Anemia, Sickle Cell - mortality
Anemias. Hemoglobinopathies
Biological and medical sciences
Black or African American
Black People
Child
Child, Preschool
Diseases of red blood cells
Emergency Service, Hospital
Female
Hematologic and hematopoietic diseases
Hospitalization
Humans
Infant
Infant, Newborn
Male
Managed Care Programs
Medical sciences
Middle Aged
mortality
Retrospective Studies
Sex Factors
sickle cell disease
State Health Plans
Tennessee
United States
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Summary:The purpose of this study was to evaluate the pattern of medical care utilization and mortality in children and adults with sickle cell disease (SCD) in the state of Tennessee. Rates of hospitalization, emergency department visits, and deaths were measured in a cohort of adults and children with SCD enrolled in TennCare, Tennessee's Medicaid managed health care program, from January 1995 to December 2002. TennCare data linked to Tennessee vital records were used to define the population and identify the outcomes. For children less than 5 years of age, the mortality rate was similar to that of other black Tennessee children (P = 0.71). Among children, the death rate was highest in 10–19 years of age and was 8‐fold higher than Tennessee's race‐ and age‐specific rate. Among 20‐ to 49‐year‐old patients with SCD, mortality was significantly higher in males than in females (P < 0.001). As compared to the black population without SCD in TennCare, patients with SCD had 7–30 times higher rate of hospitalization and 2–6 times higher rates of emergency department visits (P < 0.001). The death rate in adolescents and young adults with SCD continues to be much higher than population‐specific rates. Interventions to prevent morbidity and mortality related to SCD are urgently needed. Am. J. Hematol. 80:262–270, 2005. © 2005 Wiley‐Liss, Inc.
ISSN:0361-8609
1096-8652
DOI:10.1002/ajh.20485