Sickle cell disease-related pediatric medical expenditures in the U.S.
ABSTRACT Although it is known that people with sickle cell disease (SCD) have relatively high utilization of medical care, most previous estimates of SCD-attributable expenditures have been limited to either inpatient care or single-state data.
To extend known findings by measuring the attributable or incremental expenditures per child with SCD compared to children without this illness and to thereby estimate SCD-attributable expenditures among children in the U.S.
MarketScan Medicaid and Commercial Claims databases for 2005 were used to estimate total medical expenditures of children with and without SCD. Expenditures attributable to SCD were calculated as the difference in age-adjusted mean expenditures during 2005 for children with SCD relative to children without SCD in the two databases.
Children with SCD incurred medical expenditures that were $9369 and $13,469 higher than those of children without SCD enrolled in Medicaid and private insurance, respectively. In other words, expenditures of children with SCD were 6 and 11 times those of children without SCD enrolled in Medicaid and private insurance, respectively.
Using a large, multistate, multipayer patient sample, SCD-attributable medical expenditures in children were conservatively and approximately estimated at $335 million in 2005.
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ABSTRACT: Although sickle cell disease (SCD) is marked by high utilization of medical resources, the full cost of care for patients with SCD, including care not directly related to SCD, is unknown. The purpose of this study was to estimate the total cost of medical care for a population of children and adults with SCD. We used data from individuals diagnosed with SCD enrolled in the Florida Medicaid program during 2001–2005 to estimate total, SCD-related, and non-SCD-related cost per patient-month based on patient age at the time of health care use. Across the 4,294 patient samples, total health care costs generally rose with age, from $892 to $2,562 per patient-month in the 0–9- and 50–64-year age groups, respectively. Average cost per patient-month was $1,389. Overall, 51.8% of care was directly related to SCD, the majority of which (80.5%) was associated with inpatient hospitalizations. Notably, non-SCD-related costs were substantially higher than those reported for the general US population. These results suggest a discounted (3% discount rate) lifetime cost of care averaging $460,151 per patient with SCD. Interventions designed to prevent SCD complications and avoid hospitalizations may reduce the significant economic burden of the disease. Am. J. Hematol. 2009. © 2009 Wiley-Liss, Inc.American Journal of Hematology 05/2009; 84(6):323 - 327. · 4.00 Impact Factor
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ABSTRACT: To use health care insurance claims data from a privately insured population to estimate health care use and expenditures for infants and children aged 0 to 4 years with Down syndrome. Data from the 2004 Medstat MarketScan database were used to estimate medical care use and expenditures related to inpatient admissions, outpatient services, and prescription drug claims for children with and those without Down syndrome. Costs were further stratified by the presence or absence of a congenital heart defect (CHD). The mean medical costs for infants and children with Down syndrome were $36384 during 2004; median medical costs were $11164. Mean and median medical costs for children 0 to 4 years of age with Down syndrome were 12 to 13 times higher than for children without Down syndrome. For infants with Down syndrome and CHDs, mean and median costs were 5 to 7 times higher than for infants with Down syndrome who did not have CHDs. These findings may facilitate future assessments of the effect of the Down syndrome on the health care system.The Journal of pediatrics 09/2008; 153(2):241-6. · 4.02 Impact Factor
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ABSTRACT: There is a paucity of population-based data describing health status and use of health services among children with sickle cell disease (SCD). This study provides estimates of co-occurring conditions, health impact and utilization, and barriers to care for a national sample of children with SCD. Data were derived from the 1997-2005 National Health Interview Survey Child Sample Core. The study included 192 children aged 0-17 years with SCD whose race was reported as black or African-American, and 19,335 children without SCD of the same age and race. Parents or other knowledgeable adults reported on medical and developmental conditions, health status, and healthcare use and access. After adjusting for demographic characteristics, black children with SCD had higher odds of frequent severe headaches or migraines, intellectual disabilities, regular use of prescription medication, and fair or poor health status compared with black children without SCD. While healthcare and special education services use were generally higher for black children with SCD than for black children in the general population, those with SCD also had higher odds of reporting delays in accessing health care. The health burden for children with SCD and their families is profound and may be exacerbated by barriers to accessing comprehensive medical care. Additional study of the extent of unmet needs for U.S. children with SCD is warranted.American journal of preventive medicine 04/2010; 38(4 Suppl):S528-35. · 4.24 Impact Factor