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Acute Care Events High in Sickle Cell Disease Patients

Encounters, rehospitalizations particularly high in 18- to 30-year-olds

TUESDAY, April 6 (HealthDay News) -- Acute care encounters and rehospitalizations are frequent among patients with sickle cell disease, particularly young adults, according to research published in the April 7 issue of the Journal of the American Medical Association.

David C. Brousseau, M.D., of the Medical College of Wisconsin in Milwaukee, and colleagues analyzed 109,344 health care encounters of 21,112 people with sickle cell disease across eight geographically dispersed states that participated in the 2005 and 2006 Healthcare Cost and Utilization Project. Utilization rates were calculated for acute care and rehospitalization.

The researchers observed a mean of 2.59 encounters per patient per year in the cohort, which included 1.52 hospitalizations and 1.08 treat-and-release emergency department visits. On the high end, 18- to 30-year-olds had an encounter rate of 3.61 per patient per year, and people with public insurance had a rate of 3.22. Among 18- to 30-year-olds with public insurance, the rate was 4.80 encounters per patient per year, the highest rate observed. Approximately 29 percent of the population had no encounters. Thirty-day and 14-day rehospitalization rates were 33.4 and 22.1 percent, respectively, with 18- to 30-year-olds having the highest rates: 41.1 percent for rehospitalization within 30 days and 28.4 percent for rehospitalization within 14 days.

"By providing comprehensive, generalizable benchmarks and identifying high-risk subpopulations, these data can be used to inform efforts to improve quality of care and reduce morbidity in sickle cell disease," the authors write.

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