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Many Poor Sickle-Cell Children Lack Comprehensive Care

More low-income children with the disease use hospitals and emergency departments

THURSDAY, Dec. 4 (HealthDay News) -- More low-income children with sickle-cell disease use hospitals, emergency departments and home health care than other low-income children, and many do not receive comprehensive care, according to study findings released online Oct. 6 in advance of publication in Pediatric Blood & Cancer.

Jean L. Raphael, M.D., from Baylor College of Medicine in Houston, and colleagues retrospectively compared the health care utilization and costs associated with sickle-cell disease from 2004 to 2007 among children with sickle-cell disease (numbers ranging from 136 to 208 depending on year) and other children (numbers ranging from 208,463 to 296,741) who were members of a health plan exclusively serving low-income children.

The researchers report that in a given year, an average of 27 percent of children with sickle-cell required hospitalization and 39 percent used emergency care, and these percentages were significantly higher than in the general population. A significantly larger percentage of children with sickle-cell also used home health services. The average costs of hospitalization, emergency care and home health care were also higher for children with sickle-cell disease. The investigators found that only 63 percent of children with sickle-cell averaged one well-child check per year with a primary care provider, and only 10 percent averaged a minimum of one outpatient visit per year to a hematologist.

"Low-income children with sickle-cell disease demonstrate significantly higher health care utilization for inpatient care, emergency center care, and home health care compared to children with similar sociodemographic characteristics," Raphael and colleagues conclude. "A substantial proportion of children with sickle-cell disease may fail to meet minimum guidelines for outpatient primary and hematology comprehensive care."

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