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Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population

Sickle cell disease is a progressively debilitating genetic condition that affects red blood cells and can result in a variety of serious medical complications, reduced life expectancy, and diminished quality of life. Medicaid nationwide covered 66 percent of sickle cell disease hospitalizations in...

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Autores principales: Grady, April, Fiori, Anthony, Patel, Dhaval, Nysenbaum, Jessica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550393/
https://www.ncbi.nlm.nih.gov/pubmed/34705847
http://dx.doi.org/10.1371/journal.pone.0257796
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author Grady, April
Fiori, Anthony
Patel, Dhaval
Nysenbaum, Jessica
author_facet Grady, April
Fiori, Anthony
Patel, Dhaval
Nysenbaum, Jessica
author_sort Grady, April
collection PubMed
description Sickle cell disease is a progressively debilitating genetic condition that affects red blood cells and can result in a variety of serious medical complications, reduced life expectancy, and diminished quality of life. Medicaid nationwide covered 66 percent of sickle cell disease hospitalizations in 2004 and 58 percent of emergency department visits for the disease between 1999 and 2007. Using Medicaid data from four states with large populations that account for more than one-third of Medicaid program enrollment, we examined the characteristics of those with sickle cell disease. We found instances of mortality rates more than nine times the age-adjusted population average (in Texas, a mortality rate for Medicaid enrollees with SCD of 1.11 percent compared to 0.12 percent overall); rates of disability-related eligibility–which is associated with long-term Medicaid enrollment–of up to 69 percent; and half or more of affected enrollees having (all-cause) hospital stays, emergency department visits, and opioid prescription fills. With gene therapies on the horizon that will spur discussions of treatment coverage, costs, and outcomes for people with sickle cell disease, it is important for relevant stakeholders to understand the affected populations.
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spelling pubmed-85503932021-10-28 Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population Grady, April Fiori, Anthony Patel, Dhaval Nysenbaum, Jessica PLoS One Research Article Sickle cell disease is a progressively debilitating genetic condition that affects red blood cells and can result in a variety of serious medical complications, reduced life expectancy, and diminished quality of life. Medicaid nationwide covered 66 percent of sickle cell disease hospitalizations in 2004 and 58 percent of emergency department visits for the disease between 1999 and 2007. Using Medicaid data from four states with large populations that account for more than one-third of Medicaid program enrollment, we examined the characteristics of those with sickle cell disease. We found instances of mortality rates more than nine times the age-adjusted population average (in Texas, a mortality rate for Medicaid enrollees with SCD of 1.11 percent compared to 0.12 percent overall); rates of disability-related eligibility–which is associated with long-term Medicaid enrollment–of up to 69 percent; and half or more of affected enrollees having (all-cause) hospital stays, emergency department visits, and opioid prescription fills. With gene therapies on the horizon that will spur discussions of treatment coverage, costs, and outcomes for people with sickle cell disease, it is important for relevant stakeholders to understand the affected populations. Public Library of Science 2021-10-27 /pmc/articles/PMC8550393/ /pubmed/34705847 http://dx.doi.org/10.1371/journal.pone.0257796 Text en © 2021 Grady et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Grady, April
Fiori, Anthony
Patel, Dhaval
Nysenbaum, Jessica
Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population
title Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population
title_full Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population
title_fullStr Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population
title_full_unstemmed Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population
title_short Profile of Medicaid enrollees with sickle cell disease: A high need, high cost population
title_sort profile of medicaid enrollees with sickle cell disease: a high need, high cost population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550393/
https://www.ncbi.nlm.nih.gov/pubmed/34705847
http://dx.doi.org/10.1371/journal.pone.0257796
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