The course and correlates of high hospital utilization in sickle cell disease: Evidence from a large, urban Medicaid managed care organization
The course and correlates of high hospital utilization in sickle cell disease: Evidence from a large, urban Medicaid managed care organization
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DOI：
10.1002/ajh.21515
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发表时间：
2009-10-01
影响因子：
12.8
通讯作者：
Lanzkron, Sophie
中科院分区：
文献类型：
--
作者：
Carroll, C. Patrick;Haywood, Carlton, Jr.;Lanzkron, Sophie
尽管大多数镰状细胞病 (SCD) 患者很少住院并在家处理痛苦的危机，但仍有一小部分患者经常被送往急诊室和住院部。这个小群体占了 SCD 患者医疗保健费用的大部分。本研究使用大型城市医疗补助 MCO 连续 5 年的住院索赔数据，试图描述诊断为 SCD 且有血管闭塞危象住院史的会员的高住院患者利用率过程（至少 1 年每年平均入院 4 人或以上）。我们将高利用率者与其他患有 SCD 的成员在人口统计、医疗和精神合并症以及其他医疗保健资源的使用方面进行了比较。高利用率的会员比低利用率的会员更多地提及镰状细胞并发症。然而，住院患者的高利用率模式可能会在连续几年中放缓，并且在缓和后恢复到这种模式的情况并不常见。尽管如此，仍有一小部分人群多年来的住院利用率达到了异常高的水平。是。 J.赫马托尔。 84:666-670, 2009。(C) 2009 Wiley-Liss, Inc.
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. Am. J. Hematol. 84:666-670, 2009. (C) 2009 Wiley-Liss, Inc.