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High resource hospitalizations among children with vaso-occlusive crises in sickle cell disease

Jean L Raphael1, Minghua Mei, Brigitta U Mueller

  • 1Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer Center, Houston, Texas 77030, USA. raphael@bcm.edu

Pediatric Blood & Cancer
|May 18, 2011
PubMed

Insights

Older children with sickle cell disease (SCD) and those with secondary diagnoses like pneumonia experienced higher hospitalization costs during vaso-occlusive crises (VOCs). This highlights the need for improved care adherence in older pediatric patients.

Area of Science:

  • Pediatric Hematology
  • Healthcare Resource Utilization
  • Sickle Cell Disease Management

Background:

  • Vaso-occlusive crises (VOCs) are a primary cause of hospitalization for children with sickle cell disease (SCD).
  • Understanding factors driving high healthcare costs during VOC hospitalizations is crucial for resource allocation and patient care improvement.

Purpose of the Study:

  • To identify patient and hospital-related factors associated with high resource utilization in pediatric sickle cell disease (SCD) hospitalizations for vaso-occlusive crises (VOCs).

Main Methods:

  • Analysis of pediatric hospital discharge data (0-18 years) with a primary SCD crisis diagnosis from the 2006 Kids' Inpatient Database.
  • High resource utilization defined as hospitalizations in the highest decile of total charges.
  • Sample-weighted regression analyses were performed to identify significant predictors of high resource use.

Main Results:

  • Older children (5-18 years) had significantly higher odds of high resource hospitalizations compared to younger children (0-4 years).
  • Hospitalizations in children's hospitals showed three times the odds of high resource use compared to general hospitals.
  • Secondary diagnoses, including pneumonia and constipation, were strongly associated with increased hospitalization charges.

Conclusions:

  • Older age and the presence of secondary diagnoses are key factors contributing to high resource utilization during pediatric VOC hospitalizations.
  • Findings underscore the necessity for enhanced adherence to comprehensive care protocols in older children with SCD to prevent VOCs.
  • Standardizing management protocols for VOC complications is recommended to optimize healthcare resource use.
Abstract

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