Date of Conferral

2021

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Public Policy and Administration

Advisor

Miriam M. Ross

Abstract

Patients with sickle cell disease (SCD) utilize the emergency department (ED) frequently due to limited access to adult health care providers. Few providers are knowledgeable about caring for patients with sickle cell disease. This quantitative study’s purpose and research questions addressed whether there was a correlation between ED utilization and ED length of stay (LOS) pre- and post-enrollment in an adult comprehensive sickle cell clinic between the years of 2012 and 2017. The Donabedian framework was used to examine the structure, process, and outcomes related to the benefits of care in a sickle cell center. The independent variables of pre- and post-enrollment of patients in a sickle cell specialty center in relation to the dependent variables of ED utilization and ED LOS were analyzed using a chi-square test and a paired sample t test, and age was measured as a covariate using linear regression. Results indicated a significant difference in ED utilization between the pre- and post-enrollment groups, with an increased ED utilization in the pre-enrollment group compared to patients enrolled in the SCD clinic group. There was no statistical significance for ED LOS in the pre-enrollment group compared to the post-enrollment group. Results also indicated a significant correlation between ED utilization and age, but no significant correlation between ED LOS and age. The positive social change benefits of this study include the advantage of specialty clinics for SCD patients to prevent ED admissions because of improvements in care, the importance of SCD specialty clinics for different regions, and the role health care administrators have with implementing policies for these clinics.

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