Bridging care gaps for Sickle Cell Disease: Examining case management and healthcare utilization.

Abstract

Individuals living with sickle cell disease (SCD) experience complex medical and social needs, including high emergency department (ED) utilization, fragmented care, and systemic inequities. Disease-specific case management has emerged as a promising strategy to improve care coordination, patient outcomes, and healthcare efficiency. This mixed-methods case study examined the impact of disease-specific case management on healthcare utilization, patient-reported outcomes, and healthcare providers’ perspectives. Quantitative analysis evaluated the impact of disease-specific case management on ED and inpatient admissions, healthcare-related costs, and the length of stay for inpatient admissions. Qualitative data were collected using interviews with patients and healthcare providers, exploring utilization, bias, and barriers to healthcare. Findings indicate that disease-specific case management reduced healthcare utilization, improved patient/provider relationships, and substantially decreased cost. Patients identified greater recognition of pain and healthcare experiences. Healthcare providers identified the importance of addressing social determinants of health (SDOH), implicit bias, and coordination of care. Implications for practice, leadership, policy, and education include promotion of equitable research funding, bias-focused training, advocacy, and integration of disease-specific case management models. This study contributes to evidence supporting disease-specific case management as an effective, equitable approach to improving health outcomes and reducing disparities in SCD