An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Bou-Maroun, Laura M.; Meta, Fabien; Hanba, Curtis; Campbell, Andrew; Yanik, Gregory A.

doi:10.1002/pbc.26758

Cited by 53 publications

(53 citation statements)

References 26 publications

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“…Readmission events in paediatric SCD patients are mainly attributed to vaso-occlusive crises (Panepinto et al, 2005;Ellison & Bauchner, 2007;Bou-Maroun et al, 2018). Other factors, including older age, inpatient use of steroids, admission for pain without other SCD-related complications (Sobota et al, 2012), absence of outpatient follow-up, concomitant asthma, oxygen within 24 h of discharge and disease severity, have been identified as risk factors for readmission in paediatric SCD patients (Frei-Jones et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Hydroxycarbamide adherence and cumulative dose associated with hospital readmission in sickle cell disease: a 6‐year population‐based cohort study

et al. 2018

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Sickle cell disease (SCD) is a congenital haemoglobinopathy that causes frequent acute care/emergency room visits and hospital admissions for affected individuals. Evidence from population-based studies demonstrating the role of hydroxycarbamide (HC, also termed hydroxyurea) in reducing hospital readmission rates is limited. Our objective was to describe the use of HC and its association with acute care utilization and readmission rates using a large, nationally-representative US health insurance claims database over a 6-year period between 2009 and 2014. We identified 20 721 SCD-related inpatient and acute care encounters. Patients had been exposed to HC within 6 months prior to admission in 4263 (21%) of SCD-related admission events. HC use was more common among children aged 10-17 years and young adults aged 18-29 years. HC was associated with lower 30-day all-cause readmission rates in adults treated with average daily doses ≥1 g (odds ratio [OR], 0·72, 95% confidence interval [CI] 0·52-0·99) and doses of 0·5-1 g (OR, 0·73, 95% CI 0·57-0·93), compared to HC treatment with average daily doses of <0·5 g; adherence to HC with proportion of days covered of ≥0·80 was also associated with significantly lower 30-day all-cause readmission risks (OR, 0·59, 95% CI 0·41-0·84). Optimal therapeutic dosing and adherence to HC treatment significantly reduces 30-day readmissions among patients with SCD.

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Section: Discussionmentioning

confidence: 99%

Hydroxycarbamide adherence and cumulative dose associated with hospital readmission in sickle cell disease: a 6‐year population‐based cohort study

et al. 2018

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“…In addition to efforts to improve parent education on this topic, advocacy efforts are needed to tackle the difficult issue of insurance coverage for PGD services. Future work should also study the cost effectiveness of paying for PGD compared to the medical costs of caring for an individual with SCD . Barriers to access PGD reinforce unfair societal hierarchies.…”

Section: Discussionmentioning

confidence: 99%

Views of parents of children with sickle cell disease on pre‐implantation genetic diagnosis

Darbari

O’Brien

Hardy

et al. 2018

Pediatric Blood & Cancer

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Pre-implantation genetic diagnosis (PGD) is an option for parents who have a child with sickle cell disease (SCD) to have another child without SCD. We conducted a survey of 19 parents with at least one child with SCD to investigate views on PGD. Before education, 44% of parents were aware of PGD. All parents rated PGD education as important. All parents considering another child also reported interest in using PGD if insurance covered its costs. Parents who have a child with SCD appear to be interested in PGD and educational tools informing this group about PGD should be developed.

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“…3,4 Complications are associated with an estimated $488 million in health care economic costs. 2 VOCs are the most frequent complication of SCD 5 and are associated with more inpatient admissions and higher health care expenditures compared to admissions for other SCD-related complications. 5…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive and psychological effects of persistent pain in pediatric sickle cell disease

Connolly

Bills

Hardy

2019

Pediatric Blood & Cancer

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Background Pain is a major complication of sickle cell disease (SCD), spanning vaso‐occlusive crises and persistent pain. Although it is known that persistent pain is associated with considerable impairment in youth without SCD, little is known about the functional effects of persistent pain in SCD. The current study aimed to (a) characterize persistent pain in youth with SCD and (b) determine the extent to which youth with SCD and persistent pain differ in disease morbidity, functional impairment, and neurocognitive and psychological functioning. Procedure Eighty‐nine participants (ages 7‐16) and caregivers completed questionnaires (BRIEF [Behavior Rating Inventory of Executive Function], Conners‐3 [Conners—third edition], and PedsQL™‐SCD Module, where PedsQL is Pediatric Quality of Life Inventory). Participants completed neurocognitive tests WISC‐V [Wechsler Intelligence Scale for Children‐fifth edition], WJ‐III [Woodcock Johnson Tests of Achievement—third edition], and WIAT‐III [Wechsler Individual Achievement Test—third edition]). Youth were classified as having persistent pain if they reported daily pain for 7 days. Chi‐square and independent sample t‐test analyses were used to assess group differences (those with vs without persistent pain). Results Patients with persistent pain (n = 18) reported lower health‐related quality of life (P = .000). Caregivers were more likely to rate youth with persistent pain as having lower planning/organization abilities (P = .011) and clinically elevated symptoms of defiance/aggression and oppositional defiance (Ps = .00; .01). Patients with persistent pain demonstrated poorer working memory (P = .023) and processing speed (P = .027), and fewer demonstrating reading fluency abilities in the average or above range (P = .026). Conclusions Youth with SCD and persistent pain are at risk for psychosocial and neurocognitive impairments, suggesting that persistent pain may be an important indicator of disease burden. Furthermore, disease management may be enhanced by assessing cognitive and psychosocial functioning and incorporating interdisciplinary treatments addressing impairment associated with persistent pain.

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An analysis of inpatient pediatric sickle cell disease: Incidence, costs, and outcomes

Abstract: Objective: To identify characteristics of pediatric sickle cell disease (SCD) hospitalizations and to examine admission demographics and medical expenditures.

Cited by 53 publications

References 26 publications

Hydroxycarbamide adherence and cumulative dose associated with hospital readmission in sickle cell disease: a 6‐year population‐based cohort study

Hydroxycarbamide adherence and cumulative dose associated with hospital readmission in sickle cell disease: a 6‐year population‐based cohort study

Views of parents of children with sickle cell disease on pre‐implantation genetic diagnosis

Neurocognitive and psychological effects of persistent pain in pediatric sickle cell disease

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