Integration of neuropsychology services in a sickle cell clinic and subsequent healthcare use for pain crises. Clin Neuropsychol 2019 Oct;33(7):1195-1211
Date
11/27/2018Pubmed ID
30472925DOI
10.1080/13854046.2018.1535664Scopus ID
2-s2.0-85057267901 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
Objective: Growing literature has documented the clinical utility of neuropsychological evaluations for predicting functional outcomes, including reduced healthcare service utilization, in a variety of clinical samples. The present study investigates the relationship between the integration of clinical neuropsychology services into an existing outpatient sickle cell clinic and frequency of emergency department (ED) visits and hospitalizations for pain crises. Method: Participants included 144 adults diagnosed with sickle cell disease (SCD) who either underwent neuropsychological evaluation (NP+), including interview, neuropsychological testing, and feedback, or treatment as usual (NP-). Medical records were reviewed for a two-year period, one year prior to study enrollment (pre-assessment) and one year post-study enrollment (post-assessment), to track the number of ED visits and hospitalizations related to sickle cell pain crises. Results: When examining pain crises ED visits prior to and following neuropsychological evaluation, there was a significant decrease in ED visits for the NP + group, but no change for the NP - group. No significant changes in pain crises hospitalizations were observed for the NP + and NP - groups. For the NP + group, the decreased incidence of pain crises ED visits and hospitalizations was associated with an estimated total cost savings of $994,821. Discussion: Results highlight that integration of neuropsychology services into an existing outpatient sickle cell clinic may reduce healthcare costs, particularly use of pain crises ED services, for adults with SCD.
Author List
Janecek JK, Dorociak KE, Piper LE, Kelleher T, Pliskin NH, Gowhari M, Molokie REAuthor
Julie K. Janecek PhD Associate Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Anemia, Sickle Cell
Delivery of Health Care
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Neuropsychology
Outpatient Clinics, Hospital
Pain
Young Adult
