Risk factors for hospitalizations and readmissions among individuals with sickle cell disease

results of a U.S. survey study

Robert M. Cronin, Jane S. Hankins, Jeannie Byrd, Brandi M. Pernell, Adetola Kassim, Patricia Adams-Graves, Alexis A Thompson, Karen Kalinyak, Michael DeBaun, Marsha Treadwell

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Hospital admissions are significant events in the care of individuals with sickle cell disease (SCD) due to associated costs and potential for quality of life compromise. METHODS: This cross-sectional cohort study evaluated risk factors for admissions and readmissions between October 2014 and March 2016 in adults with SCD (n = 201) and caregivers of children with SCD (n = 330) at six centres across the U.S. Survey items assessed social determinants of health (e.g. educational attainment, difficulty paying bills), depressive symptoms, social support, health literacy, spirituality, missed clinic appointments, and outcomes hospital admissions and 30-day readmissions in the previous year. RESULTS: A majority of adults (64%) and almost half of children (reported by caregivers: 43%) were admitted, and fewer readmitted (adults: 28%; children: 9%). The most common reason for hospitalization was uncontrolled pain (admission: adults: 84%, children: 69%; readmissions: adults: 83%, children: 69%). Children were less likely to have admissions/readmissions than adults (Admissions: OR: 0.35, 95% CI: [0.23,0.52]); Readmissions: 0.23 [0.13,0.41]). For all participants, missing appointments were associated with admissions (1.66 [1.07, 2.58]) and readmissions (2.68 [1.28, 6.29]), as were depressive symptoms (admissions: 1.36 [1.16,1.59]; readmissions: 1.24 [1.04, 1.49]). In adults, difficulty paying bills was associated with more admissions, (3.11 [1.47,6.62]) readmissions (3.7 [1.76,7.79]), and higher spirituality was associated with fewer readmissions (0.39 [0.18,0.81]). DISCUSSION: Missing appointments was significantly associated with admissions and readmissions. Findings confirm that age, mental health, financial insecurity, spirituality, and clinic attendance are all modifiable factors that are associated with admissions and readmissions; addressing them could reduce hospitalizations.

Original languageEnglish (US)
Pages (from-to)189-198
Number of pages10
JournalHematology (Amsterdam, Netherlands)
Volume24
Issue number1
DOIs
StatePublished - Dec 1 2019

Fingerprint

Sickle Cell Anemia
Hospitalization
Spirituality
Appointments and Schedules
Caregivers
Social Determinants of Health
Depression
Health Literacy
Social Support
Surveys and Questionnaires
Mental Health
Cohort Studies
Cross-Sectional Studies
Quality of Life
Costs and Cost Analysis
Pain

Keywords

  • Health care utilization
  • clinic visits
  • health care surveys
  • hospital admissions
  • sickle cell disease
  • vulnerable populations

ASJC Scopus subject areas

  • Hematology

Cite this

Cronin, Robert M. ; Hankins, Jane S. ; Byrd, Jeannie ; Pernell, Brandi M. ; Kassim, Adetola ; Adams-Graves, Patricia ; Thompson, Alexis A ; Kalinyak, Karen ; DeBaun, Michael ; Treadwell, Marsha. / Risk factors for hospitalizations and readmissions among individuals with sickle cell disease : results of a U.S. survey study. In: Hematology (Amsterdam, Netherlands). 2019 ; Vol. 24, No. 1. pp. 189-198.
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title = "Risk factors for hospitalizations and readmissions among individuals with sickle cell disease: results of a U.S. survey study",
abstract = "OBJECTIVE: Hospital admissions are significant events in the care of individuals with sickle cell disease (SCD) due to associated costs and potential for quality of life compromise. METHODS: This cross-sectional cohort study evaluated risk factors for admissions and readmissions between October 2014 and March 2016 in adults with SCD (n = 201) and caregivers of children with SCD (n = 330) at six centres across the U.S. Survey items assessed social determinants of health (e.g. educational attainment, difficulty paying bills), depressive symptoms, social support, health literacy, spirituality, missed clinic appointments, and outcomes hospital admissions and 30-day readmissions in the previous year. RESULTS: A majority of adults (64{\%}) and almost half of children (reported by caregivers: 43{\%}) were admitted, and fewer readmitted (adults: 28{\%}; children: 9{\%}). The most common reason for hospitalization was uncontrolled pain (admission: adults: 84{\%}, children: 69{\%}; readmissions: adults: 83{\%}, children: 69{\%}). Children were less likely to have admissions/readmissions than adults (Admissions: OR: 0.35, 95{\%} CI: [0.23,0.52]); Readmissions: 0.23 [0.13,0.41]). For all participants, missing appointments were associated with admissions (1.66 [1.07, 2.58]) and readmissions (2.68 [1.28, 6.29]), as were depressive symptoms (admissions: 1.36 [1.16,1.59]; readmissions: 1.24 [1.04, 1.49]). In adults, difficulty paying bills was associated with more admissions, (3.11 [1.47,6.62]) readmissions (3.7 [1.76,7.79]), and higher spirituality was associated with fewer readmissions (0.39 [0.18,0.81]). DISCUSSION: Missing appointments was significantly associated with admissions and readmissions. Findings confirm that age, mental health, financial insecurity, spirituality, and clinic attendance are all modifiable factors that are associated with admissions and readmissions; addressing them could reduce hospitalizations.",
keywords = "Health care utilization, clinic visits, health care surveys, hospital admissions, sickle cell disease, vulnerable populations",
author = "Cronin, {Robert M.} and Hankins, {Jane S.} and Jeannie Byrd and Pernell, {Brandi M.} and Adetola Kassim and Patricia Adams-Graves and Thompson, {Alexis A} and Karen Kalinyak and Michael DeBaun and Marsha Treadwell",
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Cronin, RM, Hankins, JS, Byrd, J, Pernell, BM, Kassim, A, Adams-Graves, P, Thompson, AA, Kalinyak, K, DeBaun, M & Treadwell, M 2019, 'Risk factors for hospitalizations and readmissions among individuals with sickle cell disease: results of a U.S. survey study', Hematology (Amsterdam, Netherlands), vol. 24, no. 1, pp. 189-198. https://doi.org/10.1080/16078454.2018.1549801

Risk factors for hospitalizations and readmissions among individuals with sickle cell disease : results of a U.S. survey study. / Cronin, Robert M.; Hankins, Jane S.; Byrd, Jeannie; Pernell, Brandi M.; Kassim, Adetola; Adams-Graves, Patricia; Thompson, Alexis A; Kalinyak, Karen; DeBaun, Michael; Treadwell, Marsha.

In: Hematology (Amsterdam, Netherlands), Vol. 24, No. 1, 01.12.2019, p. 189-198.

Research output: Contribution to journalArticle

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T1 - Risk factors for hospitalizations and readmissions among individuals with sickle cell disease

T2 - results of a U.S. survey study

AU - Cronin, Robert M.

AU - Hankins, Jane S.

AU - Byrd, Jeannie

AU - Pernell, Brandi M.

AU - Kassim, Adetola

AU - Adams-Graves, Patricia

AU - Thompson, Alexis A

AU - Kalinyak, Karen

AU - DeBaun, Michael

AU - Treadwell, Marsha

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Y1 - 2019/12/1

N2 - OBJECTIVE: Hospital admissions are significant events in the care of individuals with sickle cell disease (SCD) due to associated costs and potential for quality of life compromise. METHODS: This cross-sectional cohort study evaluated risk factors for admissions and readmissions between October 2014 and March 2016 in adults with SCD (n = 201) and caregivers of children with SCD (n = 330) at six centres across the U.S. Survey items assessed social determinants of health (e.g. educational attainment, difficulty paying bills), depressive symptoms, social support, health literacy, spirituality, missed clinic appointments, and outcomes hospital admissions and 30-day readmissions in the previous year. RESULTS: A majority of adults (64%) and almost half of children (reported by caregivers: 43%) were admitted, and fewer readmitted (adults: 28%; children: 9%). The most common reason for hospitalization was uncontrolled pain (admission: adults: 84%, children: 69%; readmissions: adults: 83%, children: 69%). Children were less likely to have admissions/readmissions than adults (Admissions: OR: 0.35, 95% CI: [0.23,0.52]); Readmissions: 0.23 [0.13,0.41]). For all participants, missing appointments were associated with admissions (1.66 [1.07, 2.58]) and readmissions (2.68 [1.28, 6.29]), as were depressive symptoms (admissions: 1.36 [1.16,1.59]; readmissions: 1.24 [1.04, 1.49]). In adults, difficulty paying bills was associated with more admissions, (3.11 [1.47,6.62]) readmissions (3.7 [1.76,7.79]), and higher spirituality was associated with fewer readmissions (0.39 [0.18,0.81]). DISCUSSION: Missing appointments was significantly associated with admissions and readmissions. Findings confirm that age, mental health, financial insecurity, spirituality, and clinic attendance are all modifiable factors that are associated with admissions and readmissions; addressing them could reduce hospitalizations.

AB - OBJECTIVE: Hospital admissions are significant events in the care of individuals with sickle cell disease (SCD) due to associated costs and potential for quality of life compromise. METHODS: This cross-sectional cohort study evaluated risk factors for admissions and readmissions between October 2014 and March 2016 in adults with SCD (n = 201) and caregivers of children with SCD (n = 330) at six centres across the U.S. Survey items assessed social determinants of health (e.g. educational attainment, difficulty paying bills), depressive symptoms, social support, health literacy, spirituality, missed clinic appointments, and outcomes hospital admissions and 30-day readmissions in the previous year. RESULTS: A majority of adults (64%) and almost half of children (reported by caregivers: 43%) were admitted, and fewer readmitted (adults: 28%; children: 9%). The most common reason for hospitalization was uncontrolled pain (admission: adults: 84%, children: 69%; readmissions: adults: 83%, children: 69%). Children were less likely to have admissions/readmissions than adults (Admissions: OR: 0.35, 95% CI: [0.23,0.52]); Readmissions: 0.23 [0.13,0.41]). For all participants, missing appointments were associated with admissions (1.66 [1.07, 2.58]) and readmissions (2.68 [1.28, 6.29]), as were depressive symptoms (admissions: 1.36 [1.16,1.59]; readmissions: 1.24 [1.04, 1.49]). In adults, difficulty paying bills was associated with more admissions, (3.11 [1.47,6.62]) readmissions (3.7 [1.76,7.79]), and higher spirituality was associated with fewer readmissions (0.39 [0.18,0.81]). DISCUSSION: Missing appointments was significantly associated with admissions and readmissions. Findings confirm that age, mental health, financial insecurity, spirituality, and clinic attendance are all modifiable factors that are associated with admissions and readmissions; addressing them could reduce hospitalizations.

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KW - sickle cell disease

KW - vulnerable populations

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