Prediction of onset and course of high hospital utilization in sickle cell disease.
Publication/Presentation Date
5-1-2011
Abstract
BACKGROUND: Although sickle cell disease (SCD) patients typically manage their pain at home, a small subgroup is frequently hospitalized and accounts for the majority of costs.
OBJECTIVES: 1) To identify prospective diagnostic and demographic markers of new periods of high utilization; 2) To identify demographic and diagnostic markers of a persistent rather than moderating course of high utilization; 3) To replicate the finding that high utilization tends to moderate.
DESIGN: The State Inpatient Databases for California, 2004-2007, were used. Patients with new onset periods of high utilization were compared with non-high utilizers, and new high utilizers who moderated were compared with those who had a persistent course.
SETTING: All hospitals in the state of California.
PATIENTS: Patients age 13 years or older in 2004 with a recorded diagnosis of sickle cell disease and at least one hospitalization for crisis during the study period.
METHODS: Groups from hospitals throughout California were compared on demographics and discharge diagnoses of SCD complications and comorbidities. Patients age 13 years or older in 2004 with a recorded diagnosis of sickle cell disease and at least 1 hospitalization for crisis during the study period were included.
RESULTS: New periods of high utilization were associated with more prior hospitalizations and previous diagnoses of aseptic necrosis and renal disease. High utilization typically moderated. A persistent course was associated with slightly more hospitalizations during the initial year of high utilization, and, subsequently, by more mentions of septicemia and mood disorders.
CONCLUSIONS: Overall, high utilization was difficult to predict, as was its course. The diagnoses most associated with high utilization indicated more severe sickle cell disease. Septicemia deserves further investigation as a preventable cause for high utilization, as do mood disorders.
Volume
6
Issue
5
First Page
248
Last Page
255
ISSN
1553-5606
Published In/Presented At
Carroll, C. P., Haywood, C., Jr, & Lanzkron, S. (2011). Prediction of onset and course of high hospital utilization in sickle cell disease. Journal of hospital medicine, 6(5), 248–255. https://doi.org/10.1002/jhm.850
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
21661098
Department(s)
Administration and Leadership
Document Type
Article