College of Psychology: Faculty Proceedings, Presentations, Speeches and Lectures

Title

Case Study of Impact of Sickle Cell Day Unit on Adult Patient Outcomes Post Pediatric Transition

Document Type

Symposium

Presentation Date

4-3-2017

Conference Name / Publication Title

11th Annual Foundation for Sickle Cell Disease Research and Educational Symposium

Description

Background: The goal of this study is to evaluate the impact of the implementation of a sickle cell day unit (SCDU) on health care utilization (HCU) patterns and health outcomes of patients transitioning from pediatric to adult care pre- and post-implementation of a SCDU. Specifically, we will examine any changes that may have occurred in the use of acute care services since the implementation of a SCDU with a specific focus on the number and length of emergency department (ED) visits, hospital admissions, and rehospitalizations. This study will also explore associations with other important health outcomes (e.g., reticulocyte counts, ferritin levels) for this population.

Methods: The sample consists of 35 patients, ages 19 to 25 years (M = 22.48, 54% female), diagnosed with sickle cell anemia HbSS. De-identified data were extracted from electronic health records. For each hospital visit, laboratory results were analyzed. The requisite medical chart review for this analysis is in progress; findings from the complete analysis of this data will be presented. Data analyses will be conducted with the use of descriptive statistics to describe HCU and other health outcomes (e.g., ED visits, SCDU visits, hospital admissions, length of stay, etc.). All analyses will be conducted using Chi-square and t-test analyses to compare HCU and health outcomes for patients pre and postimplementation of the SCDU.

Hypotheses: The patients who transitioned from pediatric to adult care prior to the implementation of the SCDU will have an overall higher rate of HCU as compared to those patients who transitioned after the day unit was established.

Conclusion: To our knowledge, this is the first study to analyze the impact of the implementation of a SCDU on HCU in patients transitioning form pediatric to adult care. This research is warranted given previous findings that indicate high mortality risks in the young adult SCD population, particularly shortly after transition (Quinn et al., 2010). Young adults (18-30 years old) are also among the highest users of health care services. Armed with the knowledge of the impact of SCDU on HCU for newly transitioning patients, wider implementation of SCDUs in hospitals may be instrumental in ameliorating negative health outcomes for young adults with SCD.

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