PB2335: BURDEN OF HOSPITALIZATION, COSTS AND CO-MORBIDITIES IN MEDICAID PATIENTS WITH SICKLE CELL DISEASE (SCD): ANALYSIS OF NATIONAL IN-PATIENT HOSPITAL DATABASE

Abstract

Background: Sickle cell disease (SCD) is a group of inherited red blood cell disorders. SCD affects approximately 100,000 Americans. Aims: To analyze trends in hospital length of stay, total costs and co-morbidities in Medicaid patients with Sickle Cell Disease (SCD). Methods: The National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for Sickle Cell Disease (SCD). Thirty co-morbidities were assessed using Elixhauser scoring. The outcomes assessed include length of stay (LOS), total charges, co-morbidity score, mortality rate and emergency room visits. The SCD ICD-10 codes used were ‘D57.0’, ‘D57.1’, ‘D57.2’, ‘D57.4’ and ‘D57.8’. Results: There were an estimated 125,405 hospitalizations with a diagnosis of SCD, of which 53% were covered by Medicaid. The mean age was 24.17 (SD 13, Median was 24) years and 53% of the patients were female. The mean hospital length of stay for Medicaid patients with SCD was 5 (SD 6.48, Median was 3 days). The mean hospital charges were $36048 (SD $58044). The mean comorbidity score was 1.33 (SD 1.53). The in-hospital mortality rate was 0.3%. The vast majority of the patients were Black (91%), Hispanic (5%) and White (1%). The top five listed co-morbid conditions were were Chronic Pulmonary Disease (26%), Fluid and Electrolyte Disorders (18%), Hypertension (11%), Drug Abuse (11%) and Depression (9%). The second most common listed diagnosis was for asthma (J45909). The top procedure codes were for blood transfusion and Infusion Device into Superior Vena Cava. Approximately, 79% of Medicaid patients were admitted to the hospital via the emergency room visit. Summary/Conclusion: Medicaid patients with Sickle Cell Disease pose significant burden on hospitals with relatively long length of stay. Due to comorbidities of COPD, asthma and drug abuse, these patients might need special treatment management to improve overall outcomes.