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Open AccessArticle

Shared Care for Adults with Sickle Cell Disease: An Analysis of Care from Eight Health Systems

1
Department of Health Services Research Management, and Policy, University of Florida, Gainesville, FL 32610, USA
2
Department of Community Health and Family Medicine, University of Florida, Gainesville, FL 32610, USA
3
Division of Hematology and Oncology, Departments of Pediatrics, University of Florida, Gainesville, FL 32610, USA
4
Department of Pediatrics and Pathology, University of Southern California Keck School of Medicine, Los Angeles, CA 90027, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(8), 1154; https://doi.org/10.3390/jcm8081154
Received: 11 July 2019 / Revised: 30 July 2019 / Accepted: 31 July 2019 / Published: 2 August 2019
Adult sickle cell disease (SCD) patients frequently transition from pediatric hematology to adult primary care. We examined healthcare utilization for adult patients with SCD with shared care between hematologists and primary care providers (PCP). We analyzed the OneFlorida Data Trust, a centralized data repository of electronic medical record (EMR) data from eight different health systems in Florida. The number of included adults with SCD was 1147. We examined frequent hospitalizations and emergency department (ED) visits by whether the patient had shared care or single specialty care alone. Most patients were seen by a PCP only (30.4%), followed by both PCP and hematologist (27.5%), neither PCP nor hematologist (23.3%), and hematologist only (18.7%). For patients with shared care versus single specialist care other than hematologist, the shared care group had a lower likelihood of frequent hospitalizations (OR 0.63; 95% CI 0.43–0.90). Similarly, when compared to care from a hematologist only, the shared care group had a lower likelihood of frequent hospitalizations (OR 0.67; 95% CI 0.47–0.95). There was no significant relationship between shared care and ED use. When patients with SCD have both a PCP and hematologist involved in their care there is a benefit in decreased hospitalizations. View Full-Text
Keywords: sickle cell disease; shared care; primary care; electronic medical record; secondary data analysis sickle cell disease; shared care; primary care; electronic medical record; secondary data analysis
MDPI and ACS Style

Mainous, A.G., III; Rooks, B.; Tanner, R.J.; Carek, P.J.; Black, V.; Coates, T.D. Shared Care for Adults with Sickle Cell Disease: An Analysis of Care from Eight Health Systems. J. Clin. Med. 2019, 8, 1154.

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