Lack of Insurance, Hospital’s Experience in Treating Sickle Cell Affect Outcomes for People With Disease, Study Finds
People hospitalized for complications related to sickle cell disease are more likely to die if they lack health insurance or if the facility sees few patients with the disorder, according to a report presented Saturday at the American Society of Hematology annual conference, Bloomberg reports.
Sickle cell is most common among people of African, South American, Caribbean and Mediterranean decent, according to NIH. In the U.S., where two million people carry the sickle-cell disease trait, the disease mostly affects blacks, CDC reports.
The study, lead by Timothy McCavit, a pediatrician at the University of Texas Southwestern Medical Center, is based on hospital discharge records of 71,000 patients with the disease who were hospitalized between 2003 and 2005. Researchers considered the number of patients treated at the hospital, whether the hospital was an academic teaching center and the patient's socioeconomic status.
Death rates of sickle cell patients were 50% higher among hospitals that treated few patients with the disease, according to the study. In addition, uninsured sickle cell patients were twice as likely to die in the hospital of complications as those with health insurance.
The findings suggest that hospitals that treat few sickle cell disease patients might need to improve standards of care and clinical practice guidelines for sickle cell disease patients, researchers said. McCavit said that higher mortality rates for uninsured patients "should prompt greater efforts to provide coverage for this frequently underinsured population."
Michael DeBaun, director of the Sickle Cell Medical Treatment and Education Center at St. Louis Children's Hospital, said, "Very little is known in the African-American community about this disease," adding, "This is a very important study, perhaps demonstrating for the first time the importance of having regionalized care for sickle cell disease" (Olmos, Bloomberg, 12/6).
An abstract of the study is available online (.pdf).