Sickle cell disease complications: Prevalence and resource utilization

Abstract

Objectives This study evaluated the prevalence rate of vaso-occlusive crisis (VOC) episodes, rates of uncomplicated and complicated VOC episodes, and the primary reasons for emergency room (ER) visits and inpatient admissions for sickle cell disease (SCD) patients. Methods The Medicaid Analytic extracts database was used to identify adult SCD patients using claims from 01JUL2009-31DEC2012. The date of the first observed SCD claim was designated as the index date. Patients were required to have continuous medical and pharmacy benefits for ≥6 months baseline and ≥12 months follow-up period. Patient demographics, baseline clinical characteristics, the rate of uncomplicated and complicated VOC (VOC with concomitant SCD complications) episodes, and reasons for ER visits and inpatient stays were analyzed descriptively. Results A total of 8,521 patients were included in the analysis, with a median age of 30 years. The average follow-up period was 2.7 years. The rate of VOC episodes anytime in the follow-up was 3.31 in person-years. During the first-year follow-up period, an average of 2.79 VOC episodes were identified per SCD patients, with 1.06 VOC episodes treated in inpatient setting and 0.90 VOC episodes in ER without admission. A total of 76,154 VOC episodes were identified during the entire follow-up period for the overall SCD patients. Most of the VOC episodes (70.3% [n = 53,523]) were uncomplicated episodes, and 29.7% were complicated episodes. Using primary diagnosis claims only, the most frequent complications during the VOC episode were infectious diseases (25.9%), fever (21.8%), and pulmonary disorders (16.2%). Among ER and hospitalizations related to VOC or SCD complication, ~85.0% had VOCs as the primary reason for admission; 15.0% had SCD complications as the primary reason. Conclusion In summary, SCD and its related comorbidities and complications result in high acute health care utilization. In addition, VOC remains the primary reason for SCD patients’ ER visits and inpatient admissions.

Administrative data identify sickle cell disease: A critical review of approaches in U.S. health services research

“…Some researchers use the presence of ≥1 claim in any setting with an SCD diagnosis code to identify putative SCD cases. [61][62][63][69][70][71][72][73] However, owing to the frequency of false-positive diagnoses in outpatient claims, that approach can lead to misclassification and result in underestimation of the use of services or costs among individuals with SCD. 20…”

Improvement of Sickle Cell Disease Morbimortality in Children: Experience in a Remote Area of an African Country

“…The [58][59][60][61][62][63][64][65][66]. Prospective cohort studies of SCD patients are rare in Africa due to barriers to medical monitoring [37].…”

Improvement of Sickle Cell Disease Morbi-Mortality in Children: Experience Gained in a Remote Area of an African Country

“…Studies carried out in high-income countries have sufficiently demonstrated the benefits of standardized and regular medical follow-up of sickle cell patients, with a reduction in acute and chronic complications of the disease and improvement in the quality of life [58][59][60][61][62][63][64][65][66]. Prospective cohort studies of SCD patients are rare in Africa due to barriers to medical monitoring [37].…”