Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MA, USA.
Clin J Pain. 2013 Apr;29(4):317-23. doi: 10.1097/AJP.0b013e3182579b87.
To identify demographic, medical, and psychosocial characteristics that distinguished sickle cell disease (SCD) patients who were frequent utilizers of urgent or emergent care resources from low-utilizing patients.
Patients at a large urban comprehensive SCD treatment center were recruited from clinic or during urgent care visits. Participants who were high utilizers, defined as having >4 acute or emergency care visits in the prior 12 months, were compared with patients with more typical utilization patterns on lifetime complications of SCD, family background, psychiatric history, occupational function, coping, depressive symptoms, and personality.
High utilizers were nearly a decade younger on average; despite this they had a similar lifetime history of SCD complications. High-utilizing patients' parents seemed to have greater educational achievement overall. High utilizers reported a nearly 3-fold greater prevalence of psychiatric illness in family members than low utilizers. On other measures, including coping strategies, social support, and personality, the 2 groups were comparable.
The study strengthens emerging evidence that disease severity, familial factors related to greater parental education, and psychiatric illness are important factors in high care utilization in patients with SCD.
确定区分镰状细胞病（SCD）频繁使用紧急或紧急医疗资源的患者与低使用率患者的人口统计学、医学和社会心理特征。
从诊所或紧急护理就诊中招募了一家大型城市综合性 SCD 治疗中心的患者。将高使用率患者（定义为过去 12 个月中有>4 次急性或急诊就诊）与具有更典型使用率模式的患者进行比较，这些患者在 SCD 的终身并发症、家庭背景、精神病史、职业功能、应对、抑郁症状和个性方面。
高使用率患者的平均年龄要年轻近 10 岁；尽管如此，他们的 SCD 并发症终生史相似。高使用率患者的父母整体上似乎受教育程度更高。高使用率患者报告家庭成员中有近 3 倍的精神疾病患病率高于低使用率患者。在其他措施方面，包括应对策略、社会支持和个性，两组患者相当。
该研究加强了以下证据，即疾病严重程度、与父母受教育程度较高相关的家庭因素以及精神疾病是 SCD 患者高护理利用率的重要因素。
