OBJECTIVES: Sickle cell disease (SCD), affecting ~100,000 Americans, is the most common inherited blood disorder in the US and is associated with significant morbidity and cost. This study aims to determine the variation in SCD hospitalization outcomes across 2 HCUP datasets.

METHODS: The 2019 National Inpatient Sample Survey (NIS) and 2019 Nationwide Readmissions Database (NRD) from the Health Care and Utilization Project (HCUP) were used to assess SCD hospitalization (ICD10 code D57).

RESULTS: We identified 18,282 SCD-related hospitalizations in NIS and 50,206 hospitalizations in NRD for 19,377 unique patients (average 2.6 hospitalizations per patient). In the NIS data, hospitalized patients were Black (90%), average age of 28 years, and 53% were female. Medicaid paid for 50% of hospitalizations followed by Medicare (26%) and private insurers (18%). Average length of stay (LOS) per hospitalization was 4.9 ± 5.0 days with total charges of $39,287 ± $97,271. In the NRD, LOS and total charge for all hospitalizations were added to compute total LOS and total charges per patient. The average LOS per SCD patient was 11 ±14.7 days. The mean LOS for women was 1.4 days more than men (11.9 versus 10.5 days, p≤0.001). The mean LOS per patient was highest for Medicare (14 days), followed by Medicaid (11.5 days) and private insurers (8.7 days). Total charges were $84,876 ± $115,666 per patient. Medicare had the highest charges $105,277 ± 131,554 followed by Medicaid $87,040 ± $122,245 and finally Private insurance $ 68,017± $85,782.

CONCLUSIONS: The NRD dataset provides a detailed view of the SCD related hospitalizations at the patient level. The NRD demonstrates a much more significant burden of SCD LOS and charges than previously expected from NIS data alone.