National Quality Indicators in Pediatric Sickle Cell Anemia

Area of Science:

• Hematology
• Pediatric Health
• Quality Improvement

Background:

• Pediatric sickle cell anemia (SCA) requires consistent medical care.
• Nationally endorsed quality measures aim to standardize and improve care for children with SCA.
• Assessing adherence to these measures is crucial for identifying gaps in care delivery.

Purpose of the Study:

• To evaluate the adherence to two key quality measures in pediatric sickle cell anemia (SCA) care.
• To assess the proportion of children receiving recommended antibiotic prophylaxis and transcranial Doppler (TCD) ultrasounds.
• To identify demographic and clinical factors associated with variations in quality measure performance.

Main Methods:

• Utilized data from the Sickle Cell Data Collection programs in California and Georgia (2010-2019).
• Evaluated antibiotic prophylaxis receipt (≥300 days) in children aged 3 months to 5 years.
• Assessed transcranial Doppler (TCD) ultrasound receipt (≥1 annually) in children aged 2 to 15 years.

Main Results:

• Low adherence to antibiotic prophylaxis: 22.2% in California and 15.5% in Georgia.
• Higher odds of prophylaxis associated with rural residence in Georgia and a trend with pediatric hematologist prescription.
• Moderate adherence to TCD screening: 47.4% in California and 52.7% in Georgia, increasing with age and annually.

Conclusions:

• Receipt of recommended antibiotic prophylaxis and annual TCD screenings was low among children with SCA.
• These quality measures are trackable and can inform policies to improve survival in SCA.
• Opportunities exist to enhance care delivery and outcomes for pediatric SCA patients.