This project will improve the efficiency and quality of healthcare for persons with sickle cell disease, an under-served and at risk population by implementing a co-management model of care. Many patients with sickle cell disease (SCD) receive care primarily from specialty physicians and emergency departments (ED), thus resulting in a lack of primary care and a high number of ED visits and hospitalizations. The goal is to improve PCP and SCD specialist co-management. The overall purpose of this dissemination project is to evaluate utilization data, as well as patient and provider reported outcomes associated with the dissemination of a toolbox of decision support tools to PCP's and ED providers across NC and SC.
The investigators will achieve the goals stated above through three aims. 1. Examine the effects of decision support tools on study outcomes during the 12 months prior to project start and across the 3.5 years of the project in NC and SC. The investigators will also determine which patient and practice level characteristics predict study outcomes. 2. Evaluate individual provider-reported awareness, use and preference of health maintenance tables and algorithms amongst PCPs and ED providers in NC and SC at project start and yearly across the project. Additionally, the investigators will explore patient reported awareness of and satisfaction with co-management model of care in NC and SC. 3. The investigators will conduct an exploratory cost analysis of the dissemination and implementation of the SCD co-management model and its effect on healthcare resource utilization.
Study Type
OBSERVATIONAL
Enrollment
4,392
Community Care of North Carolina
Raleigh, North Carolina, United States
HU refills
number of hydroxyurea prescription refills per patient
Time frame: 12 months
Co-management visits
number of co-management visits per patient
Time frame: 12 months
ED visits
number of visits to the emergency department per patient
Time frame: 12 months
In-patient hospitalizations
number of in-patient hospitalizations per patient
Time frame: 12 months
Re-admission to hospital within 30 days
number of re-admissions per patient over the course of one year
Time frame: 12 months
Primary care visits
number of visits to primary care provider per patient
Time frame: 12 months
Specialty visits
number of specialty care visits per patient
Time frame: 12 months
Transcranial doppler screening
number of transcranial doppler screenings per patient
Time frame: 12 months
Opioid prescription fills
number of opioid prescription fill days per patient
Time frame: 12 months
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