Sickle Cell Disease
Conditions
Keywords
Co-management model of care, Primary Care, Specialty Care, Decision support tools, Emergency Department Clinicians, Co-management
Brief summary
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.
Detailed description
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.
Interventions
None listed
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
Duke University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* patient with diagnosis of sickle cell disease, emergency department clinician, or primary care clinician in the state of NC or part of SC
Exclusion criteria
* Non-English speaking, non-resident of NC or SC
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HU refills | 12 months | number of hydroxyurea prescription refills per patient |
| Co-management visits | 12 months | number of co-management visits per patient |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Re-admission to hospital within 30 days | 12 months | number of re-admissions per patient over the course of one year |
| Primary care visits | 12 months | number of visits to primary care provider per patient |
| ED visits | 12 months | number of visits to the emergency department per patient |
| Transcranial doppler screening | 12 months | number of transcranial doppler screenings per patient |
| Opioid prescription fills | 12 months | number of opioid prescription fill days per patient |
| Specialty visits | 12 months | number of specialty care visits per patient |
| In-patient hospitalizations | 12 months | number of in-patient hospitalizations per patient |
Countries
United States
Outcome results
None listed