Search tips
Search criteria 


Logo of jnmaLink to Publisher's site
J Natl Med Assoc. 2007 March; 99(3): 192–196.
PMCID: PMC2569638

Socioeconomic status and length of hospital stay in children with vaso-occlusive crises of sickle cell disease.


OBJECTIVE: To examine the association between socioeconomic status and length of hospital stay for vaso-occlusive crises in children with sickle cell disease. METHODS: 19,174 discharges (aged 1-20 years), with a primary diagnosis of sickle cell disease with crisis were analyzed from the Healthcare Cost and Utilization Project Kid Inpatient Database 2000. Socioeconomic status was assessed using an area-based measure, median household income by ZIP code and an individual-level measure, insurance status. We adjusted for age, gender, hospital location/teaching status, presence of pneumonia, number of diagnoses on record and number of procedures performed. Negative binomial regression models using generalized estimating equations (GEE) were used to assess length of stay. RESULTS: Socioeconomic status as measured by income was not associated with length of stay (incidence rate ratio (highest versus lowest category) = 1.04 (95% CI: 0.98, 1.11)). In contrast, socioeconomic status as measured by insurance was associated with length of stay [adjusted incidence rate ratio = 1.04 (95% CI: 1.01, 1.08)), although the magnitude of this difference is small and not likely to be clinically important. CONCLUSIONS: We found no evidence to suggest that socioeconomic status has any clinically important effect on length of hospital stay in children with vaso-occlusive crises in sickle cell disease.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (889K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Pollack W, Ascari WQ, Kochesky RJ, O'Connor RR, Ho TY, Tripodi D. Studies on Rh prophylaxis. 1. Relationship between doses of anti-Rh and size of antigenic stimulus. Transfusion. 1971 Nov-Dec;11(6):333–339. [PubMed]
  • Schechter MS, Margolis PA. Relationship between socioeconomic status and disease severity in cystic fibrosis. J Pediatr. 1998 Feb;132(2):260–264. [PubMed]
  • Petrou Stavros, Kupek Emil. Socioeconomic differences in childhood hospital inpatient service utilisation and costs: prospective cohort study. J Epidemiol Community Health. 2005 Jul;59(7):591–597. [PMC free article] [PubMed]
  • Halfon N, Newacheck PW. Childhood asthma and poverty: differential impacts and utilization of health services. Pediatrics. 1993 Jan;91(1):56–61. [PubMed]
  • Castro M, Schechtman KB, Halstead J, Bloomberg G. Risk factors for asthma morbidity and mortality in a large metropolitan city. J Asthma. 2001 Dec;38(8):625–635. [PubMed]
  • Carr W, Zeitel L, Weiss K. Variations in asthma hospitalizations and deaths in New York City. Am J Public Health. 1992 Jan;82(1):59–65. [PubMed]
  • Houston-Yu Patricia, Rana Sohail R, Beyer Betsy, Castro Oswaldo. Frequent and prolonged hospitalizations: a risk factor for early mortality in sickle cell disease patients. Am J Hematol. 2003 Mar;72(3):201–203. [PubMed]
  • Platt OS, Thorington BD, Brambilla DJ, Milner PF, Rosse WF, Vichinsky E, Kinney TR. Pain in sickle cell disease. Rates and risk factors. N Engl J Med. 1991 Jul 4;325(1):11–16. [PubMed]
  • Merenstein Dan, Egleston Brian, Diener-West Marie. Lengths of stay and costs associated with children's hospitals. Pediatrics. 2005 Apr;115(4):839–844. [PubMed]
  • Panepinto Julie A, Brousseau David C, Hillery Cheryl A, Scott J Paul. Variation in hospitalizations and hospital length of stay in children with vaso-occlusive crises in sickle cell disease. Pediatr Blood Cancer. 2005 Feb;44(2):182–186. [PubMed]
  • Blood Anthony. North American Interview Board. Br Med J. 1968 Jan 20;1(5585):b186–186. [PMC free article]
  • Davis H, Gergen PJ, Moore RM., Jr Geographic differences in mortality of young children with sickle cell disease in the United States. Public Health Rep. 1997 Jan-Feb;112(1):52–58. [PMC free article] [PubMed]
  • Powars DR. Natural history of sickle cell disease--the first ten years. Semin Hematol. 1975 Jul;12(3):267–285. [PubMed]
  • Epstein AM, Stern RS, Weissman JS. Do the poor cost more? A multihospital study of patients' socioeconomic status and use of hospital resources. N Engl J Med. 1990 Apr 19;322(16):1122–1128. [PubMed]
  • Epstein AM, Stern RS, Tognetti J, Begg CB, Hartley RM, Cumella E, Jr, Ayanian JZ. The association of patients' socioeconomic characteristics with the length of hospital stay and hospital charges within diagnosis-related groups. N Engl J Med. 1988 Jun 16;318(24):1579–1585. [PubMed]
  • Miller ST, Sleeper LA, Pegelow CH, Enos LE, Wang WC, Weiner SJ, Wethers DL, Smith J, Kinney TR. Prediction of adverse outcomes in children with sickle cell disease. N Engl J Med. 2000 Jan 13;342(2):83–89. [PubMed]
  • Platt OS, Brambilla DJ, Rosse WF, Milner PF, Castro O, Steinberg MH, Klug PP. Mortality in sickle cell disease. Life expectancy and risk factors for early death. N Engl J Med. 1994 Jun 9;330(23):1639–1644. [PubMed]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association