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Costs, charges, and reimbursements for persons with sickle cell disease
P J Nietert1, M R Abboud, J S Zoller
1Center for Health Care Research, Medical University of South Carolina, Charleston 29425, USA.
Insights
Patients with sickle cell disease (SCD) incur significant health care costs, with a small percentage of patients accounting for a large portion of charges. Geographic distance and painful respiration diagnoses predict higher costs.
Area of Science:
- Health Economics
- Hematology
- Public Health
Background:
- Sickle cell disease (SCD) is a genetic blood disorder requiring ongoing medical care.
- Understanding healthcare utilization and costs is crucial for resource allocation and patient management.
Purpose of the Study:
- To delineate healthcare costs and charges for patients with SCD.
- To identify key predictors associated with high healthcare utilization among SCD patients.
Main Methods:
- Utilized International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes to identify 947 SCD patients from administrative databases (1996-1997).
- Collected clinical and administrative data for hospital admissions and ambulatory visits.
- Employed logistic regression models to ascertain predictors of high healthcare use.
Main Results:
- SCD patients averaged 0.9 admissions and 8.0 outpatient visits annually.
- Mean inpatient charges were $7290, with 40% of charges from only 4.2% of patients.
- Living distantly and diagnosis of painful respiration predicted excessive healthcare charges.
Conclusions:
- Patients with SCD are high-frequency users of healthcare services.
- Healthcare costs and charges exhibit disproportionate distribution among SCD patients.
- Geographic distance and painful respiration diagnosis are significant predictors of elevated hospital charges.
Purpose:
The aims of this study were to describe health care costs and charges for patients with sickle cell disease (SCD) and identify predictors of high use.
Patients And Methods:
Patients with SCD were identified by International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes from a university hospital's administrative databases from January 1, 1996, to September 30, 1997. Clinical and administrative data were gathered on each patient for all hospital admissions and ambulatory clinic visits. Logistic regression models were used to determine predictors of high health care use.
Results:
A total of 947 patients with SCD were identified, 73% of whom resided within three South Carolina counties. On average, there were 0.9 admissions per patient per year and 8.0 outpatient visits per patient per year. Mean inpatient hospital charges, physician charges, and direct hospital costs per admission were $7290, $1589, and $5405, respectively, and the average length of stay was 4.5 days. Mean hospital charges, physician charges, and direct hospital costs per outpatient visit were $305, $169, and $688, respectively. Forty percent of the inpatient hospital charges were accounted for by only 4.2% of the patients. Residing in a distant county and being admitted with a diagnosis of painful respiration were found to be predictors of excessive charges and expenses beyond expected reimbursements.
Conclusions:
Patients with SCD are frequent users of health care services. Charges and costs are distributed disproportionately across these patients. Predictors of excessive hospital charges include living geographically distant from the hospital and being admitted with a diagnosis of painful respiration.