Social and Behavioral Factors in Sickle Cell Disease: Employment Predicts Decreased Health Care Utilization

J Health Care Poor Underserved. 2018;29(2):814-829. doi: 10.1353/hpu.2018.0060.

Abstract

to determine frequency of health care encounters among people with sickle cell disease (SCD) seeking treatment for a vaso-occlusive crisis (VOC). Health care encounters are categorized by visit type (day hospital, ED visit, hospitalization), prevalence of self-reported behavioral and social factors, and any associations between behavioral and social factors and health care encounters. Ninety-five people with SCD were enrolled in a prospective descriptive study in North Carolina. Patients were interviewed concerning behavioral-social factors, and a report of health care encounters was produced, generated by ICD codes associated with VOCs between October 2011 and March 2014. Among 95 patients, there were a total of 839 day hospital and 1,990 ED visits, and 1,101 hospital admissions. Prevalent behavioral and social factors were depression (29%), anxiety (34%), illicit drug use (6%); unstable home situation (17%); and unemployment (81%). Employment and stable home were significantly associated with decreased frequency of health care encounters.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Sickle Cell / psychology
  • Anemia, Sickle Cell / therapy*
  • Employment / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Prospective Studies
  • Socioeconomic Factors
  • United States
  • Young Adult