Department of Medicine, William Osler Health System, Brampton, ON, Canada.
University Health Network, University of Toronto, Toronto, ON, Canada.
Hemoglobin. 2022 Mar;46(2):91-94. doi: 10.1080/03630269.2022.2073888. Epub 2022 May 13.
Comprehensive care for patients with sickle cell disease has been shown to improve morbidity. However, few studies have focused on community hospitals where the burden of disease is highest. From 2017 to 2019, a series of quality improvement interventions was implemented in Brampton, Toronto, ON, Canada, directed toward pediatric and adult sickle cell disease populations. This included a new adult clinic and education directed at patients and healthcare providers. There were 206 visits from 88 unique patients at the clinic and hydroxyurea (HU) uptake increased from 41.0 to 60.0% over that time ( < 0.001). The annual admission rate by adult patients before and after intervention was 90.0 and 75.0% respectively ( = 0.010). The length of stay of pediatric patients decreased from 3.5 to 2.9 days ( = 0.039). These interventions resulted in significant improvements in acute care utilization and HU use by sickle cell disease patients locally, but larger studies are required to confirm these findings.
综合性护理可改善镰状细胞病患者的发病率。然而，很少有研究关注疾病负担最高的社区医院。2017 年至 2019 年，在加拿大安大略省多伦多的宾顿市实施了一系列针对儿科和成人镰状细胞病患者的质量改进干预措施，包括一个新的成人诊所和针对患者和医疗保健提供者的教育。该诊所共接待了 88 名独特患者的 206 次就诊，在此期间，羟基脲（HU）的使用率从 41.0%增加到 60.0%（<0.001）。干预前后成年患者的年入院率分别为 90.0%和 75.0%（=0.010）。儿科患者的住院时间从 3.5 天减少到 2.9 天（=0.039）。这些干预措施显著改善了当地镰状细胞病患者的急性护理利用和 HU 使用率，但需要更大规模的研究来证实这些发现。
