Individuals with sickle cell disease who have regular visits with outpatient hematologists have lower rates of emergency department revisits, according to a study recently published in Pediatric Blood & Cancer.
The researchers used Medicaid administrative claims data, collected by the Sickle Cell Data Collection Program, to identify 2,794 individuals with SCD from California and 3641 from Georgia. Index emergency department visits occurred between January 1, 2015, and November 30, 2018, and revisits were examined for the 30-day period after the index visit.
In Georgia, one quarter of identified individuals with sickle cell disease had an emergency department revisit and 38.5% did not have a hematology encounter in the preceding year. Individuals with one or two prior year hematology encounters had the lowest percentage of emergency department revisits (20.5%).
In California, 26.1% of identified individuals had an emergency department revisit and 60.9% did not have a hematology encounter in the preceding year. The 20-29 and 30-39 age groups had the highest percentage of individuals with an emergency department revisit (30.6% and 29.3%, respectively). Those individuals with six or more hematology encounters had the lowest percentage of revisits.
In both states, those with six or more primary care provider encounters had the highest percentage of revisits.
“These findings highlight the importance of access to specialty hematology care among people with sickle cell disease,” says study coauthor, Angie Snyder, Ph.D., from the Georgia Health Policy Center, which houses the Georgia Sickle Cell Data Collection Program. “The reason behind the correlation between primary care encounters and higher numbers of emergency department revisits is not clear from our data and requires further investigation, but could be due to lack of receipt of disease-modifying therapies, as they require specialized expertise to prescribe and access to a chemotherapy dispensing pharmacy for hydroxyurea.”
Read the full study here.