Age-related healthcare services utilization for the management of sickle cell disease among treated Texas Medicaid patients. Issue 4 (27th October 2021)

• Record Type: Journal Article
• Authors: Shukla, Nidhi; Barner, Jamie C; Lawson, Kenneth A; Rascati, Karen L
• Is Part Of: Journal of pharmaceutical health services research. Volume 12:Issue 4(2021)
• Page Start: 523
• Page End: 530
• Publication Date: 2021-10-27
• Subjects: sickle cell disease -- healthcare services utilization -- hydroxyurea; Pharmacy -- Research -- Periodicals; Drugs -- Research -- Periodicals; Medical care -- Research -- Periodicals; Public health -- Research -- Periodicals; Pharmaceutical industry -- Periodicals; Health Services Research -- Periodicals; Economics, Pharmaceutical -- Periodicals; 615.1072
• DOI: 10.1093/jphsr/rmab056
• Languages: English
• ISSNs: 1759-8885

Abstract

Abstract: Objectives: To determine if there are age-related differences in sickle cell disease (SCD)-related healthcare utilization and to describe temporal healthcare utilization following an emergency department (ED) visit or hospitalization in treated SCD patient population. Methods: Texas Medicaid prescription and medical claims from 1 September 2011 to 31 August 2016 were used. Patients aged 2–63 years with at least one inpatient or outpatient SCD medical claim and receiving one or more SCD-related medications (hydroxyurea, opioid or non-opioid analgesics) were included. The primary outcomes were utilization of SCD-related ED, inpatient and outpatient visits, all-cause prescription medications and type of SCD-related service at index and subsequent healthcare services. Age group was the primary independent variable. Key findings: Overall ( N = 2339), healthcare service utilization was relatively higher among age groups 2–12, 18–25 and 26–40. Proportions of patients having ≥1 ED and ≥1 inpatient visits, respectively, were significantly higher among age groups 2–12 (33.2%; 23.0%), 18–25 (29.3%; 25.1%) and 26–40 (32.3%; 22.4%) as compared with age group 13–17 (21.3%; 12.9%). The number of outpatient visits was highest among children aged 2–12 (4.5 ± 7.6, P < 0.0001), while mean number of all-cause medications was the highest for older adults aged 41–63 (22.4 ± 16.3; P < 0.0001). After an index ED visit ( N = 598), outpatient visits were the most prevalent healthcare services. After an index hospitalization ( N = 203), a subsequent hospitalization was the most prevalent healthcare service. Conclusions: Texas Medicaid SCD patients receiving treatment have a high use of healthcare services, especially among children and young adults who are transitioning from childhood to adulthood. Age-specific interventions should be developed to promote optimal care transitions among young adults.