The relationship of socio-environmental factors with hospital admissions and readmissions for Sickle Cell Disease

Abstract

Background Though approximately 100,000 Americans have sickle cell disease (SCD), studies over long time periods and large geographic areas in the US are limited. Patients routinely have multiple hospital admissions per year. Identification of potential contributing socio-environmental factors is important to advance prevention efforts.Methods We conducted a descriptive study of SCD hospital encounters and readmissions by individual and area-level socio-environmental factors using representative encounter data from all hospitals in South Carolina. We obtained emergency department visit and hospital admission data from 2002 through 2013 for patients with a primary diagnosis related to SCD. We examined initial visits, total encounters, admission and readmission rates by individual and area-level socio-environmental factors.Results We identified 127,598 hospital encounters with complete data that were attributed to 6,631 individual patients. Average overall encounter rate was 19.2 (95% CI: 17.9, 20.6) and rate of readmissions within 30 days was 11.5 (95% CI: 10.2, 12.8). Encounter rates and readmission rates were lower among participants living in more affluent areas. Further, those who had Medicaid as their primary insurance had the highest rates of readmission.Conclusions We observed some suggestion of increased SCD-related hospital admission rates and readmissions among participants living in less affluent areas, thus prevention efforts may be warranted for these underserved communities.