Springhill Care Group - Sickle Cell Patients Rely On ER to Adult Health Care

[Springhill Care]

http://news.springhillcaregroup.net/

Patients with sickle cell disease move from pediatric to adult health care because they now depend more on the emergency room, says researchers at Washington University School of Medicine in St. Louis.

 
Reported at the American Society of Hematology's annual meeting in Atlanta, more than 3,200 patients with sickle cell disease demonstrates that emergency room visits tripled from age 15 to age 24 this is according to the study of Medicaid data.  

According to hematologist Morey A. Blinder, MD, associate professor of medicine, "There seems to be a breakdown in medical care during the transition from childhood to adulthood.  Not only emergency department usage, but hospitalizations go up during this time as well."

Blinder further added that one possible explanation for the increased reliance on emergency care is the relative lack of adult health care providers with experience caring for sickle cell patients.  Alarming similar issues are arising for other pediatric diseases, such as cystic fibrosis and hemophilia.  The said illnesses were previously fatal.  What is more sad about the problem is over the past few decades the number of children and teenagers are living into adulthood with these conditions increased.  What makes the matters worse is there often aren't enough primary care physicians who can provide care for these adult patients. 

Many are not familiar to the understanding of the sickle cell disease.  It refers to a number of inherited genetic conditions the “sickle” shape red blood cells aren’t normal, they are suppose to be normally round, disk-like red blood cells.  The problems with these malformed red blood cells are prone to clogging smaller blood vessels and they do not carry oxygen to the body as well as healthy cells.  The condition often causes pain in places the cells block blood flow that sometimes causes more severe complications include blindness, strokes and pneumonia.

 
Medical patients from five states including Florida, New Jersey, Missouri, Iowa and Kans in mid 1990s through 2010 with sickle cell disease were examined.  The 3,200 patients were subject to studies for an average of six years each and included those moving from pediatric to adult care. 

The result of the study showed that emergency department visits increasing from 0.76 per quarter at age 15 to more than two per quarter at age 24, meaning it   tripled over nine years.  The use of emergency care increased at almost three visits per quarter or about one per month at age 36.  Reliance on emergency care did not come back to the lesser ranks seen in childhood even by age 50.

As a result more emergency care and hospitalizations have higher overall medical costs.  It reached total health care costs of $7,000 higher per quarter for patients making heavier use of the emergency department, even as they tended to spend less on medication, perhaps simply failing to fill prescriptions. 

Blinder says the St. Louis region and Missouri in general have good support for adults with sickle cell disease, though this is not always the case nationally. 

"In areas without good adult support for this disease, you have to identify adult physicians who would be interested in treating sickle cell patients," Blinder says. "They could be hematologists or even internists, but in general there are not enough providers for adult sickle cell patients.

"This study highlights an emerging problem in transitioning pediatric age patients to adulthood, and the need to explore new ways to facilitate that process," Blinder says.