Missed Opportunities for Transcranial Doppler Screening Among Children With Sickle Cell Disease

被引：13
作者：
Reeves, Sarah L. [1 ,2 ]
Fullerton, Heather J. [3 ]
Cohn, Lisa M. [2 ]
Dombkowski, Kevin J. [2 ]
Boulton, Matthew L. [1 ]
Braun, Thomas M. [1 ]
Lisabeth, Lynda D. [1 ,4 ]
机构：
[1] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Dept Pediat, Ann Arbor, MI 48109 USA
[3] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA
[4] Univ Michigan, Dept Neurol, Ann Arbor, MI USA
来源：
CLINICAL PEDIATRICS | 2016年 / 55卷 / 12期
关键词：
sickle cell disease; pediatric stroke; stroke prevention; transcranial Doppler screening; health services research; children; Medicaid; newborn screening; PRIMARY STROKE PREVENTION; CARE UTILIZATION; POPULATION; ANEMIA; RATES; GUIDELINES; EFFICACY; QUALITY; RISK;
D O I：
10.1177/0009922815614351
中图分类号：
R72 [儿科学];
学科分类号：
100202 ;
摘要：
Transcranial Doppler (TCD) screening rates remain low among children with sickle cell disease (SCD). We assessed TCD screening rates and missed opportunities for TCD screening. Children 2 to 16 years old with SCD enrolled in Michigan Medicaid for 1 year (2007-2011) were identified through newborn screening. Receipt of TCD screening and presence of a missed opportunity (1 SCD-related outpatient visit, no TCD screening) were identified through administrative claims. Potential correlates of missed opportunities included SCD-related health services, comorbidities, and demographics. Logistic regression with generalized estimating equations modeled associations between a missed opportunity and correlates. Overall, 353 children contributed 1066 person-years. TCD screening was low yearly (10%-32%); missed opportunities occurred in 73% of the person-years. Increasing age (odds ratio [OR] = 1.11; confidence interval CI = 1.07, 1.15), previous TCD screening (OR = 0.26; CI = 0.16, 0.41), and 4 to 5 (OR = 0.48; CI = 0.26, 0.87) or 6 outpatient visits (OR = 0.26; CI = 0.14, 0.49) were associated with a missed opportunity. Reduction of missed opportunities is a potential strategy to increase TCD screening rates.
引用
收藏
页码：1093 / 1099
页数：7
相关论文
共 35 条
[1]   Long-term stroke risk in children with sickle cell disease screened with transcranial Doppler [J].
Adams, RJ ;
McKie, VC ;
Carl, EM ;
Nichols, FT ;
Perry, R ;
Brock, K ;
McKie, K ;
Figueroa, R ;
Litaker, M ;
Weiner, S ;
Brambilla, D .
ANNALS OF NEUROLOGY, 1997, 42 (05) :699-704
[2]   Prevention of a first stroke by transfusions in children with sickle, cell anemia and abnormal results on transcranial Doppler ultrasonography [J].
Adams, RJ ;
McKie, VC ;
Hsu, L ;
Files, B ;
Vichinsky, E ;
Pegelow, C ;
Abboud, M ;
Gallagher, D ;
Kutlar, A ;
Nichols, FT ;
Bonds, DR ;
Brambilla, D ;
Woods, G ;
Olivieri, N ;
Driscoll, C ;
Miller, S ;
Wang, W ;
Hurlett, A ;
Scher, C ;
Berman, B ;
Carl, E ;
Jones, AM ;
Roach, ES ;
Wright, E ;
Zimmerman, RA ;
Waclawiw, M ;
Pearson, H ;
Powars, D ;
Younkin, D ;
El-Gammal, T ;
Seibert, J ;
Moye, L ;
Espeland, M ;
Murray, R ;
McKinley, R ;
McKinley, S ;
Hagner, S ;
Weiner, S ;
Estow, S ;
Yelle, M ;
Brock, K ;
Carter, E ;
Chiarucci, K ;
Debarr, M ;
Feron, P ;
Harris, S ;
Hoey, L ;
Jacques, K ;
Kuisel, L ;
Lewis, N .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (01) :5-11
[3]  
American Medical Association, CODEMANAGER
[4]  
[Anonymous], 2004, Applied Longitudinal Analysis
[5]   Utilization of TCD screening for primary stroke prevention in children with sickle cell disease [J].
Armstrong-Wells, J. ;
Grimes, B. ;
Sidney, S. ;
Kronish, D. ;
Shiboski, S. C. ;
Adams, R. J. ;
Fullerton, H. J. .
NEUROLOGY, 2009, 72 (15) :1316-1321
[6]   The costs of children with sickle cell anemia: Preparing for managed care [J].
Bilenker, JH ;
Weller, WE ;
Shaffer, TJ ;
Dover, GJ ;
Anderson, GF .
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, 1998, 20 (06) :528-533
[7]   Caregivers' Perspectives on Barriers to Transcranial Doppler Screening in Children With Sickle-Cell Disease [J].
Bollinger, Lindsay M. ;
Nire, Kidan G. ;
Rhodes, Melissa M. ;
Chisolm, Deena J. ;
O'Brien, Sarah H. .
PEDIATRIC BLOOD & CANCER, 2011, 56 (01) :99-102
[8]   Health Status and Healthcare Use in a National Sample of Children with Sickle Cell Disease [J].
Boulet, Sheree L. ;
Yanni, Emad A. ;
Creary, Melissa S. ;
Olney, Richard S. .
AMERICAN JOURNAL OF PREVENTIVE MEDICINE, 2010, 38 (04) :S528-S535
[9]   STROKE IN CHILDREN WITHIN A MAJOR METROPOLITAN-AREA - THE SURPRISING IMPORTANCE OF INTRACEREBRAL HEMORRHAGE [J].
BRODERICK, J ;
TALBOT, GT ;
PRENGER, E ;
LEACH, A ;
BROTT, T .
JOURNAL OF CHILD NEUROLOGY, 1993, 8 (03) :250-255
[10]   Pediatrician self-efficacy for counseling parents of asthmatic children to quit smoking [J].
Cabana, MD ;
Rand, C ;
Slish, K ;
Nan, B ;
Davis, MM ;
Clark, N .
PEDIATRICS, 2004, 113 (01) :78-81
1234