Emergency Department Utilization for Patients Living With Sickle Cell Disease: Psychosocial Predictors of Health Care Behaviors - 12/09/20
, Ashley Buscetta, MSN a, Kayla Cooper, BA a, Julia Byeon, BA a, Andrew Crouch, BA b, Sabrina Pink, PhD b, Caterina Minniti, MD b, Vence L. Bonham, JD aAbstract |
Study objective |
Individuals living with sickle cell disease (SCD) often require urgent care; however, some patients hesitate to present to the emergency department (ED), which may increase the risk of serious clinical complications. Our study aims to examine psychosocial, clinical, and demographic factors associated with delaying ED care.
Methods |
This was a cross-sectional study of 267 adults with SCD from the national INSIGHTS Study. The binary outcome variable asked whether, in the past 12 months, participants had delayed going to an ED when they thought they needed care. Logistic regression was performed with clinical, demographic, and psychosocial measures.
Results |
Approximately 67% of the participants reported delaying ED care. Individuals who delayed care were more likely to have reported higher stigma experiences (odds ratio [OR]=1.09; 95% confidence interval [CI] 1.03 to 1.16), more frequent pain episodes (OR=1.15; 95% CI 1.01 to 1.32), lower health care satisfaction (OR= 0.74; 95% CI 0.59 to 0.94), and more frequent ED visits (OR=6.07; 95% CI 1.18 to 31.19). Disease severity and demographics, including sex, age, and health insurance status, were not significantly associated with delay in care.
Conclusion |
Psychosocial factors, including disease stigma and previous negative health care experiences, are associated with delay of ED care in this SCD cohort. There is a need to further investigate the influence of psychosocial factors on the health care–seeking behaviors of SCD patients, as well as the downstream consequences of these behaviors on morbidity and mortality. The resulting knowledge can contribute to efforts to improve health care experiences and patient-provider relationships in the SCD community.
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| Supervising editor: Donald M. Yealy, MD. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). This work was supported in part by the Division of Intramural Research, National Human Genome Research InstituteZIAHG200394. Publication of this supplement was supported by the Office of Minority Health of the US Department of Health and Human Services. |
Vol 76 - N° 3S
P. S56-S63 - septembre 2020 Retour au numéro
Article précédent
- Utility of Point-of-Care Lung Ultrasonography for Evaluating Acute Chest Syndrome in Young Patients With Sickle Cell Disease
- Stephanie G. Cohen, Zayir M. Malik, Sam Friedman, Stephen Russell, Robert Hagbom, Adina Alazraki, Courtney E. McCracken, Janet Figueroa, Olufolake A. Adisa, Reshika D. Mendis, Shaminy Manoranjithan, Harold K. Simon, Claudia R. Morris
- A Survey-Based Needs Assessment of Barriers to Optimal Sickle Cell Disease Care in the Emergency Department
- Elizabeth A. Linton, Dania A. Goodin, Jane S. Hankins, Julie Kanter, Liliana Preiss, Jena Simon, Kimberly Souffront, Paula Tanabe, Robert Gibson, Lewis L. Hsu, Allison King, Lynne D. Richardsona, Jeffrey A. Glassberg, Sickle Cell Disease Implementation Consortium
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