TY - JOUR
T1 - The course and correlates of high hospital utilization in sickle cell disease
T2 - Evidence from a large, urban Medicaid managed care organization
AU - Carroll, C. Patrick
AU - Carlton, Haywood
AU - Fagan, Peter
AU - Lanzkron, Sophie
PY - 2009/10
Y1 - 2009/10
N2 - Although most patients with sickle cell disease (SCD) are hospitalized infrequently and manage painful crises at home, a small subpopulation is frequently admitted to emergency departments and inpatient units. This small group accounts for the majority of health care expenses for patients with SCD. Using inpatient claims data from a large, urban Medicaid MCO for 5 consecutive years, this study sought to describe the course of high inpatient utilization (averaging four or more admissions enrolled per year for at least 1 year) in members with a diagnosis of SCD and a history of hospitalizations for vaso-occlusive crisis. High utilizers were compared with the other members with SCD on demographics, medical and psychiatric comorbidity, and use of other health care resources. Members who were high utilizers had more diagnostic mentions of sickle cell complications than low utilizers. However, the pattern of high inpatient utilization was likely to moderate over successive years, and return to the pattern after moderation was uncommon. Despite this, a small subpopulation engaged in exceptional levels of inpatient utilization over multiple years.
AB - Although most patients with sickle cell disease (SCD) are hospitalized infrequently and manage painful crises at home, a small subpopulation is frequently admitted to emergency departments and inpatient units. This small group accounts for the majority of health care expenses for patients with SCD. Using inpatient claims data from a large, urban Medicaid MCO for 5 consecutive years, this study sought to describe the course of high inpatient utilization (averaging four or more admissions enrolled per year for at least 1 year) in members with a diagnosis of SCD and a history of hospitalizations for vaso-occlusive crisis. High utilizers were compared with the other members with SCD on demographics, medical and psychiatric comorbidity, and use of other health care resources. Members who were high utilizers had more diagnostic mentions of sickle cell complications than low utilizers. However, the pattern of high inpatient utilization was likely to moderate over successive years, and return to the pattern after moderation was uncommon. Despite this, a small subpopulation engaged in exceptional levels of inpatient utilization over multiple years.
UR - http://www.scopus.com/inward/record.url?scp=70349492889&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349492889&partnerID=8YFLogxK
U2 - 10.1002/ajh.21515
DO - 10.1002/ajh.21515
M3 - Article
C2 - 19743465
AN - SCOPUS:70349492889
SN - 0361-8609
VL - 84
SP - 666
EP - 670
JO - American journal of hematology
JF - American journal of hematology
IS - 10
ER -