Acute Care Use Among People With Sickle Cell Disease, Sickle Cell Data Collection Program, 8 US States, 2018

OBJECTIVES: Understanding patterns of hospital admissions and emergency department (ED) visits among people with sickle cell disease is critical for improving care and access to care for this population. The objective of this study was to characterize acute care use among people with sickle cell disease and identify patterns of use across age groups and sex using 2018 data.

METHODS: We conducted a cross-sectional study using population-based data from 8 states participating in the Centers for Disease Control and Prevention's Sickle Cell Data Collection program. The sample population consisted of children, adolescents, and adults with a confirmed or probable diagnosis of sickle cell disease, regardless of acute care use, in 2018. We analyzed data on hospital admissions, ED treat-and-release (T/R) visits, and readmissions after ED T/R or inpatient discharge, aggregated from each participating state.

RESULTS: The 2018 cohort of the Sickle Cell Data Collection program consisted of 27 034 people; 40.2% had ≥1 hospital admission, and 57.0% had ≥1 ED T/R visit. Of the 98 617 people using acute care, 93.6% (n = 92 305) involved the ED in some capacity.

CONCLUSIONS: Hospital admissions were frequent and occurred in less than half of the study population. More than half used the ED, with most hospital admissions initiated in the ED. Our findings call for further research to better understand differences in acute care use, high rates of ED T/R visits, and treatment of sickle cell disease in an outpatient setting.