Concentration of hospital care for acute sickle cell disease-related visits

Ja Panepinto, Pl Owens, Al Mosso, Claudia Angelica Steiner, Dc Brousseau

Research output: Contribution to journalArticle

Abstract

Background: Sickle cell disease (SCD) is characterized by frequent disease-related events that require acute care. It is unknown to what extent patients utilize multiple hospitals for acute care. We examined the continuity pattern of acute care visits to the hospital or emergency department. We hypothesized that among patients with multiple SCD related acute care visits, children experience more concentrated hospital care than adults and privately insured patients experience more concentrated hospital care than publicly insured patients. Procedure: We conducted a retrospective cohort study using data from the 2005 and 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. Subjects included patients with SCD ≥1 year of age. The primary outcome was proportion of patients with multiple acute care visits to a single hospital. Results: A total of 13,533 patients made ≥2 acute SCD-related visits. Of the 5,030 children, 77.3% went to the same hospital for all visits. In contrast, of the 8,503 adults, only 51.3% visited the same hospital. Adolescents were more likely than adults to go to one hospital [adjusted relative risk (ARR) 1.40, confidence interval (CI) 1.35-1.45]. Those with public insurance and the uninsured had a decreased probability of using one hospital (ARR 0.96, CI 0.94-0.99, and ARR 0.83, CI 0.79-0.88, respectively). Conclusions: Adults and patients with public insurance or no insurance are more likely to use multiple hospitals for acute care. By receiving acute care at multiple hospitals, patients with SCD experience dispersed and fragmented care potentially leading to decreased care quality. Pediatr Blood Cancer 2012;59:685-689.

Original languageEnglish (US)
Pages (from-to)685-689
Number of pages5
JournalPediatric Blood and Cancer
Volume59
Issue number4
DOIs
StatePublished - Oct 2012
Externally publishedYes

Fingerprint

Sickle Cell Anemia
Insurance
Confidence Intervals
Hospital Emergency Service
Databases
Quality of Health Care
Hospital Departments
Child Care
Health Care Costs
Inpatients
Cohort Studies
Retrospective Studies

Keywords

  • Access to care
  • Continuity of care
  • Minority health
  • Utilization

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Panepinto, J., Owens, P., Mosso, A., Steiner, C. A., & Brousseau, D. (2012). Concentration of hospital care for acute sickle cell disease-related visits. Pediatric Blood and Cancer, 59(4), 685-689. https://doi.org/10.1002/pbc.24028

Concentration of hospital care for acute sickle cell disease-related visits. / Panepinto, Ja; Owens, Pl; Mosso, Al; Steiner, Claudia Angelica; Brousseau, Dc.

In: Pediatric Blood and Cancer, Vol. 59, No. 4, 10.2012, p. 685-689.

Research output: Contribution to journalArticle

Panepinto, J, Owens, P, Mosso, A, Steiner, CA & Brousseau, D 2012, 'Concentration of hospital care for acute sickle cell disease-related visits', Pediatric Blood and Cancer, vol. 59, no. 4, pp. 685-689. https://doi.org/10.1002/pbc.24028
Panepinto, Ja ; Owens, Pl ; Mosso, Al ; Steiner, Claudia Angelica ; Brousseau, Dc. / Concentration of hospital care for acute sickle cell disease-related visits. In: Pediatric Blood and Cancer. 2012 ; Vol. 59, No. 4. pp. 685-689.
@article{a29d8814c5c94428acf570094b5d0500,
title = "Concentration of hospital care for acute sickle cell disease-related visits",
abstract = "Background: Sickle cell disease (SCD) is characterized by frequent disease-related events that require acute care. It is unknown to what extent patients utilize multiple hospitals for acute care. We examined the continuity pattern of acute care visits to the hospital or emergency department. We hypothesized that among patients with multiple SCD related acute care visits, children experience more concentrated hospital care than adults and privately insured patients experience more concentrated hospital care than publicly insured patients. Procedure: We conducted a retrospective cohort study using data from the 2005 and 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. Subjects included patients with SCD ≥1 year of age. The primary outcome was proportion of patients with multiple acute care visits to a single hospital. Results: A total of 13,533 patients made ≥2 acute SCD-related visits. Of the 5,030 children, 77.3{\%} went to the same hospital for all visits. In contrast, of the 8,503 adults, only 51.3{\%} visited the same hospital. Adolescents were more likely than adults to go to one hospital [adjusted relative risk (ARR) 1.40, confidence interval (CI) 1.35-1.45]. Those with public insurance and the uninsured had a decreased probability of using one hospital (ARR 0.96, CI 0.94-0.99, and ARR 0.83, CI 0.79-0.88, respectively). Conclusions: Adults and patients with public insurance or no insurance are more likely to use multiple hospitals for acute care. By receiving acute care at multiple hospitals, patients with SCD experience dispersed and fragmented care potentially leading to decreased care quality. Pediatr Blood Cancer 2012;59:685-689.",
keywords = "Access to care, Continuity of care, Minority health, Utilization",
author = "Ja Panepinto and Pl Owens and Al Mosso and Steiner, {Claudia Angelica} and Dc Brousseau",
year = "2012",
month = "10",
doi = "10.1002/pbc.24028",
language = "English (US)",
volume = "59",
pages = "685--689",
journal = "Pediatric Blood and Cancer",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Concentration of hospital care for acute sickle cell disease-related visits

AU - Panepinto, Ja

AU - Owens, Pl

AU - Mosso, Al

AU - Steiner, Claudia Angelica

AU - Brousseau, Dc

PY - 2012/10

Y1 - 2012/10

N2 - Background: Sickle cell disease (SCD) is characterized by frequent disease-related events that require acute care. It is unknown to what extent patients utilize multiple hospitals for acute care. We examined the continuity pattern of acute care visits to the hospital or emergency department. We hypothesized that among patients with multiple SCD related acute care visits, children experience more concentrated hospital care than adults and privately insured patients experience more concentrated hospital care than publicly insured patients. Procedure: We conducted a retrospective cohort study using data from the 2005 and 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. Subjects included patients with SCD ≥1 year of age. The primary outcome was proportion of patients with multiple acute care visits to a single hospital. Results: A total of 13,533 patients made ≥2 acute SCD-related visits. Of the 5,030 children, 77.3% went to the same hospital for all visits. In contrast, of the 8,503 adults, only 51.3% visited the same hospital. Adolescents were more likely than adults to go to one hospital [adjusted relative risk (ARR) 1.40, confidence interval (CI) 1.35-1.45]. Those with public insurance and the uninsured had a decreased probability of using one hospital (ARR 0.96, CI 0.94-0.99, and ARR 0.83, CI 0.79-0.88, respectively). Conclusions: Adults and patients with public insurance or no insurance are more likely to use multiple hospitals for acute care. By receiving acute care at multiple hospitals, patients with SCD experience dispersed and fragmented care potentially leading to decreased care quality. Pediatr Blood Cancer 2012;59:685-689.

AB - Background: Sickle cell disease (SCD) is characterized by frequent disease-related events that require acute care. It is unknown to what extent patients utilize multiple hospitals for acute care. We examined the continuity pattern of acute care visits to the hospital or emergency department. We hypothesized that among patients with multiple SCD related acute care visits, children experience more concentrated hospital care than adults and privately insured patients experience more concentrated hospital care than publicly insured patients. Procedure: We conducted a retrospective cohort study using data from the 2005 and 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. Subjects included patients with SCD ≥1 year of age. The primary outcome was proportion of patients with multiple acute care visits to a single hospital. Results: A total of 13,533 patients made ≥2 acute SCD-related visits. Of the 5,030 children, 77.3% went to the same hospital for all visits. In contrast, of the 8,503 adults, only 51.3% visited the same hospital. Adolescents were more likely than adults to go to one hospital [adjusted relative risk (ARR) 1.40, confidence interval (CI) 1.35-1.45]. Those with public insurance and the uninsured had a decreased probability of using one hospital (ARR 0.96, CI 0.94-0.99, and ARR 0.83, CI 0.79-0.88, respectively). Conclusions: Adults and patients with public insurance or no insurance are more likely to use multiple hospitals for acute care. By receiving acute care at multiple hospitals, patients with SCD experience dispersed and fragmented care potentially leading to decreased care quality. Pediatr Blood Cancer 2012;59:685-689.

KW - Access to care

KW - Continuity of care

KW - Minority health

KW - Utilization

UR - http://www.scopus.com/inward/record.url?scp=84864932537&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864932537&partnerID=8YFLogxK

U2 - 10.1002/pbc.24028

DO - 10.1002/pbc.24028

M3 - Article

C2 - 22180290

AN - SCOPUS:84864932537

VL - 59

SP - 685

EP - 689

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 4

ER -