Adams-Graves Patricia, Ostric Elizabeth J, Martin Mary, Richardson Pat, Lewis James B
University of Tennessee Health Science Center, Memphis, USA.
J Healthc Manag. 2008 Sep-Oct;53(5):305-15; discussion 316-7.
American urban hospitals often serve large populations of sickle cell disease (SCD) patients. Those hospitals that choose to implement an adult SCD-specific inpatient unit have the opportunity to acquire multiple operational benefits. Such units may ultimately reduce patient morbidity and mortality; improve timely access to quality medical care in a cost-effective manner; reduce overcrowding in the emergency department; and increase patient, family, physician, and payer satisfaction. SCD is a serious, painful, genetic blood disorder that affects a growing population of adults in the United States. A single mistake in the gene that codes for hemoglobin causes crescent-shaped red blood cells that are sticky, are stiff, and have a short life span. These cells cause blockages, tremendous pain brought on by lack of oxygen in the muscles, organ damage, stroke, and problems with infections. The cells' short life span often results in anemia. The unpredictable pain event-sickle cell disease with crisis-is the most common reason for presentation to the emergency department and for hospital admission. For many SCD patients, the emergency department process and the general, overly conservative approach to pain relief lead to a delay in treatment and prolong needless suffering. Regional Medical Center at Memphis (Tennessee) established an SCD unit and developed an inpatient care delivery model that decreases the burden of caring for SCD patients on its busy emergency department, improves SCD patients' satisfaction and access to timely quality care, and reduces the needless pain and suffering of SCD patients. This SCD model may be replicated in large urban hospitals with a daily SCD patient census of five or more.
美国城市医院常常为大量镰状细胞病（SCD）患者提供服务。那些选择设立成人镰状细胞病专科住院病房的医院有机会获得诸多运营效益。这样的病房最终可能降低患者的发病率和死亡率；以具有成本效益的方式改善及时获得优质医疗护理的机会；减少急诊科的过度拥挤情况；并提高患者、家属、医生和付款人的满意度。镰状细胞病是一种严重、痛苦的遗传性血液疾病，在美国影响着越来越多的成年人。编码血红蛋白的基因出现一个错误就会导致红细胞呈新月形，这些红细胞黏性大、僵硬且寿命短。这些细胞会造成堵塞、因肌肉缺氧带来剧痛、器官损伤、中风以及感染问题。细胞的短寿命常常导致贫血。不可预测的疼痛发作——伴有危机的镰状细胞病——是患者前往急诊科就诊和住院的最常见原因。对许多镰状细胞病患者而言，急诊科的流程以及一般过于保守的疼痛缓解方法导致治疗延误，延长了不必要的痛苦。田纳西州孟菲斯市的区域医疗中心设立了一个镰状细胞病病房，并制定了一种住院护理提供模式，该模式减轻了繁忙急诊科照顾镰状细胞病患者的负担，提高了镰状细胞病患者的满意度以及及时获得优质护理的机会，并减少了镰状细胞病患者不必要的疼痛和痛苦。这种镰状细胞病模式可在每日镰状细胞病患者普查人数为五人或更多的大型城市医院中推广。
