title: Hospital utilization patterns and costs for adult sickle cell patients in Illinois.
abstract: OBJECTIVE
  To determine population size, demographic characteristics, hospital utilization patterns, the specialties of physicians providing care, and costs for hospitalized adult sickle cell patients in Illinois.
  
  
  METHODS
  A statewide, administrative dataset for the two-year period from january 1992 through December 1993 was analyzed retrospectively.
  
  
  RESULTS
  There were 8403 admissions among 1189 individual sickle cell patients for the two-year period. Eighty-five percent of patients resided in the Chicago metropolitan area. The median age of the 1189 patients was 29; two-thirds had Medicaid or Medicare coverage. Emergency departments were the primary source of admissions (85.7%). The most common admitting diagnosis was painful crisis (97.4%), and average length of stay was four days. The median number of admissions per patient was three; most patients (85%) used only one or two hospitals. A small group used more than four hospitals and accounted for 23% of statewide admissions. Primary care physicians cared for most patients, and total hospitalization charges were more than $59 million.
  
  
  CONCLUSIONS
  In Illinois the adult sickle cell population is concentrated in major urban centers, primarily the Chicago metropolitan area. These patients accounted for approximately 8400 admissions and more than $59 million in hospital charges during the two-year study period. A small group of patients used multiple hospitals and accounted for more than 23% of total hospitalization charges. This study shows the necessity of and provides a useful framework for developing targeted programs for adult sickle cell patients as well as for training physicians to efficiently provide comprehensive health care services for this population.
authors.affiliation: Department of Medicine, Medical College of Georgia, Augusta 30912, USA. kwoods@mail.mcg.edu
authors.forename: K
authors.initials: K
authors.lastname: Woods
authors.forename: T
authors.initials: T
authors.lastname: Karrison
authors.forename: M
authors.initials: M
authors.lastname: Koshy
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.forename: P
authors.initials: P
authors.lastname: Friedmann
authors.forename: C
authors.initials: C
authors.lastname: Cassel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000755:Anemia, Sickle Cell / Q000191:economics* / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D017722:Hospital Charges; D017721:Hospital Costs / Q000706:statistics & numerical data / Q000639:trends*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012189:Retrospective Studies