Background: Sickle cell disease (SCD) interferes with oxygen delivery to tissues caused by a mutation in the b-globin gene alleles with at least one sickle cell mutation. Sickle cell disease affects approximately 100,000 Americans and occurs in about 1 in 365 African American births. With the increasing number of SCD patients, the number of hospitalizations in the US are also increasing with each year.

Objective: To characterize SCD hospital discharges and study impact of socio-economic factors on Length of Stay (LOS) and Total charges using the 2017 HCUP data.

Methods: The study design is a retrospective cohort study using AHRQ’s Healthcare Cost and Utilization Project (HCUP) data for 2017. The patient population was identified using the ICD-10 code.

Results: For the 19,072 discharges analyzed, the mean age was 27.76 (±13.084) and female constituted 57%. The total number of in-hospital deaths with SCD was 55 (0.3%). Majority of the hospitalizations had either Medicaid (50.5%) or Medicare (26.2%) as payers. Approximately 90% patients were African American, and 808 (4.2%) patients were Hispanic. The average LOS was 4.88 (±4.830). Disproportionate hospitalizations were from the lowest income household (50.5%) compared to only 9.5% from the highest income household. These data are consistent with the prior analysis of the HCUP 2000 to 2016 data. Univariate tests demonstrate an association between socio-economic determinants such as age, gender, race, and payer status and hospitalization characteristics such as LOS and Total charges.

Conclusion: SCD has significant impact on African American patients and patients from low-income households due to significant hospitalization and cost burden. Healthcare policy programs need to factor in these learnings to ensure equitable care.