Development of a New Adult Sickle Cell Disease Center Within an Academic Cancer Center: Impact on Hospital Utilization Patterns and Care Quality

Andemariam, Biree; Jones, Sasia

doi:10.1007/s40615-015-0142-7

Cited by 11 publications

(13 citation statements)

References 23 publications

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“…To reduce inconsistency of care, specialized hemoglobinopathy centers should be established. Previously, access to such centers was found to be associated with better survival in thalassemia patients [27] , and improved compliance and quality indicators in SCD patients [28] . Specialized hemoglobinopathy centers provide comprehensive, coordinated, patientcentered care and allow smooth transition from pediatric to adult care.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, specialized staff members provide support to patients and families by addressing psychological and social needs. When compared with an "episodic" model of care, enrollment of SCD patients in comprehensive care programs was found to reduce cost, utilization of emergency department, length of hospitalization, and rate of readmission [28,29] . Quality of life outcomes were found to be poor in hemoglobinopathy patients compared to the general population [30][31][32] .…”

Section: Discussionmentioning

confidence: 99%

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Clinical Complications of Hemoglobinopathies in Western Saudi Arabia and the Need for Specialized Care Centers

et al. 2019

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In the absence of specialized care centers for hemoglobinopathies in Saudi Arabia, there are insufficient data on prevalence of clinical complications in this population. This is a retrospective record review about the clinical complications associated with hemoglobinopathies at King Abdulaziz University Hospital, for patients followed between January 1st 2010 through June 30th 2016. A total of 349 patients were included, with a mean age of 25.45 years, including 266 with sickle cell disease and 80 with thalassemia. Of those receiving regular transfusions, 17.5% developed alloantibodies, 16.6% tested positive for hepatitis C virus antibodies and the mean ferritin level was 2487 ng/ml. Almost half of the patients were screened for renal disease, and more than 50% were found to have proteinuria. Of 203 patients with recent echocardiograms, 15.8% had pulmonary hypertension. Thirty-one (8.9%) patients died at a mean age of 28.5 years. In conclusion, the prevalence of disease related complications is high in hemoglobinopathies. Our results reiterate the need for specialized care hemoglobinopathy centers, which can further improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Complications of Hemoglobinopathies in Western Saudi Arabia and the Need for Specialized Care Centers

et al. 2019

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“…Others have described programmatic re-organizations similar to ours and with similar impacts upon acute services utilization [44,50,51,53,54]. A common feature of all of these reports is that they do not mention conflict.…”

Section: Discussionmentioning

confidence: 63%

“…Providers from several institutions have reported successful initiatives to reduce high utilization. Many of these focus upon PLOS ONE creation of a day hospital or infusion center for the administration of parenteral opioids, as well as other treatments, outside of the ED or an inpatient unit [44,[50][51][52][53][54]. This approach generally has reduced ED visits, hospital days, and associated costs, and presumably decreased patient inconvenience and increased patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Utilization, financial outcomes and stakeholder perspectives of a re-organized adult sickle cell program

et al. 2020

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In 2011 Yale New Haven Hospital, in response to high utilization of acute care services and widespread patient and health care personnel dissatisfaction, set out to improve its care of adults living with sickle cell disease. Reorganization components included recruitment of additional personnel; relocating inpatients to a single nursing unit; reducing the number of involved providers; personalized care plans for pain management; setting limits upon access to parenteral opioids; and an emphasis upon clinic visits focused upon home management of pain as well as specialty and primary care. Outcomes included dramatic reductions in inpatient days (79%), emergency department visits (63%), and hospitalizations (53%); an increase in outpatient visits (31%); and a decrease in costs (49%). Providers and nurses viewed the reorganization and outcomes positively. Most patients reported improvements in pain control and life style; many patients thought the reorganization process was unfair. Their primary complaint was a lack of shared decision-making. We attribute the contrast in these perspectives to the inherent difficulties of managing recurrent acute and chronic pain with opioids, especially within the context of the imbalance in wellness, power, and privilege between persons living with sickle cell disease, predominantly persons of color and poor socioeconomic status, and health care organizations and their personnel.

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“…Our results align and expand recent reports of reduction in healthcare utilization in patients with SCD 8 that have shown a 16%-50% reduction in uncomplicated SCD crises. 9,10 ACS is a life-threatening complication of VOC. 4…”

Section: Supporting Informationmentioning

confidence: 99%

Comprehensive management reduces incidence and mortality of acute chest syndrome in patients with sickle cell disease

et al. 2018

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Development of a New Adult Sickle Cell Disease Center Within an Academic Cancer Center: Impact on Hospital Utilization Patterns and Care Quality

Abstract: Findings suggest that embedding adult SCD centers within existing cancer centers can positively impact patterns of health care utilization and improve the quality of care.

Cited by 11 publications

References 23 publications

Clinical Complications of Hemoglobinopathies in Western Saudi Arabia and the Need for Specialized Care Centers

Clinical Complications of Hemoglobinopathies in Western Saudi Arabia and the Need for Specialized Care Centers

Utilization, financial outcomes and stakeholder perspectives of a re-organized adult sickle cell program

Comprehensive management reduces incidence and mortality of acute chest syndrome in patients with sickle cell disease

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