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Psychosocial risk and health care utilization in pediatric sickle cell disease

Kerri E Woodward1,2, Yelena L Johnson1,2, Lindsey L Cohen3

  • 1Aflac Cancer and Blood Disorders Center, Children's Health care of Atlanta, Atlanta, Georgia, USA.

Pediatric Blood & Cancer
|May 25, 2021
PubMed

Insights

Psychosocial screening in pediatric sickle cell disease (SCD) identifies families at higher risk for increased healthcare use. The Psychosocial Assessment Tool (PAT) can help tailor support for these children and families.

Area of Science:

  • Pediatric Hematology
  • Psychosocial Medicine
  • Healthcare Management

Background:

  • Sickle cell disease (SCD) in children leads to significant pain and complications, resulting in high healthcare utilization.
  • Psychosocial screening is crucial for identifying at-risk families in chronic pediatric conditions to optimize care and resource allocation.

Purpose of the Study:

  • To evaluate the effectiveness of psychosocial screening in predicting increased healthcare utilization among pediatric patients with SCD.
  • To determine if psychosocial risk status modifies the relationship between pain frequency and healthcare utilization in youth with SCD.

Main Methods:

  • A cohort of 74 pediatric patients (8-18 years) with SCD and their parents were recruited from specialized clinics.
  • Parents completed the Psychosocial Assessment Tool (PAT) to categorize family risk (Universal, Targeted, Clinical).
  • Pain frequency was self-reported by youth, and healthcare utilization was extracted from medical records. ANOVA and moderation analyses were used.

Main Results:

  • Families were classified as Universal (56.8%), Targeted (29.7%), or Clinical (13.5%) risk.
  • Patients in the Targeted risk group reported significantly higher pain frequency compared to the Universal group.
  • Clinical psychosocial risk significantly amplified the association between pain frequency and healthcare utilization.

Conclusions:

  • The Psychosocial Assessment Tool (PAT) can identify families with elevated distress and predict higher healthcare utilization in pediatric sickle cell disease.
  • Integrating PAT into routine care can help providers identify families needing enhanced psychosocial or medical support.
  • This approach can optimize the management of sickle cell disease by addressing psychosocial factors impacting healthcare needs.
Abstract

Keywords:
health care utilizationpainpediatricspsychosocial risksickle cell disease

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