TABLE 2.
Health and Healthcare Articles Included in Review
| Author (Year) | Research Design | Study Population | SDoH Variables | Results |
|---|---|---|---|---|
| Access to Healthcare | ||||
| Kayle (2020) | Retrospective | 3635 adults (US) | Insurance type | Medicaid expansion did not improve enrollment or ACU |
| Carroll (2018) | Prospective | 73 adults (US) | SES, ACU | SES and pain-related anxiety increased ACU in patients with SCD |
| Brodsky (2017) | Retrospective | 88 adults (US) | PCP, insurance type, ACU | Absence of PCP and ACU frequency increased 30-day readmission |
| Jacob (2016) | Cross-sectional | 38 adults (US) | Barriers to care | Parents of patients with SCD reported more barriers to care due to the gap in primary care |
| Smeltzer (2016) | Prospective observational | 545 children (US) | Distance to CSCC | Greater distance to CSCC decreased hospital admissions |
| Liem (2014) | Cross-sectional | 200 adults (US) | Primary care access, barriers to ACU, PCP | More access to PCP associated with less ED visits |
| Boulet (2010) | Probability sample survey | 19427 children (US) | Barriers to healthcare access | Patients with SCD reported delay in accessing care and worse health outcomes |
| Raphael (2009) | Cross-sectional | 296949 children (US) | Medicaid coverage, gaps in insurance | Low-income children with SCD had more ACU and higher expenses |
| Shankar (2008) | Cross-sectional | 1214 children (US) | Distance to CSCC | Neighborhoods with CSCC facilities observed less outpatient visits & more hospitalizations |
| Haque (2000) | Cross-sectional | 1189 adults/children (US) | Socioeconomic disparity, rural/urban access | Rural patients had low SES/more barriers to SCD clinic; urban patients had more medical issues |
| Hand (1995) | Retrospective | 172 Adolescents/Adults (US) | Insurance type, Primary /Specialty care use | Stable insurance (Medicare) and primary care did not affect ACU for patients with SCD |
| Health Literacy | ||||
| Carden (2016) | Cross-sectional | 142 adults (US) | Health literacy, disease knowledge | Lack of disease specific knowledge increased ED visits |
| Cronin (2019) | Cross-sectional | 530 adults (US) | Financial insecurity, social support, health literacy | Missed clinic visits due to financial problems increased hospitalizations/readmissions |
| Morrison (2018) | Cross-sectional | 100 adults (US) | Health literacy, pain treatment skills | Children of parents who underdosed pain medicine had more ED visits for pain |
*
SES = Socioeconomic status, SCD = Sickle Cell Disease, ED = Emergency Department, ACU = Acute Care Utilization, PCP = Primary Care Provider, CSCC = Comprehensive Sickle Cell Center, US = United States