Conflict of interest: Nothing to declare.
Sickle-cell disease in California: A population-based description of emergency department utilization†
Article first published online: 24 NOV 2010
Copyright © 2010 Wiley-Liss, Inc.
Pediatric Blood & Cancer
Volume 56, Issue 3, pages 413–419, March 2011
How to Cite
Wolfson, J. A., Schrager, S. M., Coates, T. D. and Kipke, M. D. (2011), Sickle-cell disease in California: A population-based description of emergency department utilization. Pediatr. Blood Cancer, 56: 413–419. doi: 10.1002/pbc.22792
- Issue published online: 10 JAN 2011
- Article first published online: 24 NOV 2010
- Manuscript Accepted: 20 JUL 2010
- Manuscript Received: 26 JAN 2010
- Los Angeles Basin Clinical and Translational Science Institute
- emergency department;
- health services;
- sickle-cell disease;
Acute and chronic clinical manifestations of sickle-cell disease (SCD) lead to significant healthcare utilization, especially of the emergency department (ED). Limited population-level data are available in SCD with the ability to connect patients to visits, leaving us with minimal description of utilization patterns.
Using ED discharge data with links between patients and visits, we sought to describe the California SCD population and its ED utilization patterns across facilities. Non-public California Office of Statewide Health Planning and Development data employ unique patient identifiers, linking patients, and visits.
SCD patients of all ages are heavily reliant on Medicaid (46%). The majority of SCD Californians visit an ED more than once during a year (69%), but only a minority use more than one facility during a year (34%). However, adults with SCD have multiple visits and utilize multiple EDs in higher proportions than do children (72% vs. 60% and 40% vs. 21%, respectively). A higher proportion of visits to the ED are made by SCD adults, but a higher proportion of visits by children result in hospital admission. Uninsured adults outnumber uninsured children (16% vs. 5%).
ED utilization by the California SCD population is described on a population level. Utilization patterns by adults point towards increased utilization in the population no longer eligible for Title V pediatric coverage for their disease. Further investigation using population-level socioeconomic and geographic correlates is warranted to evaluate the factors leading to ED utilization in SCD. Pediatr Blood Cancer 2011;56:413–419. © 2010 Wiley-Liss, Inc.