Quantifying Social Disadvantage For Patients With Sickle Cell Disease: Implications For Quality Of Care

Background: Socioeconomic disadvantage negatively affects healthcare utilization and disease outcomes. The Area Deprivation Index (ADI) is a well-established method for quantifying socioeconomic disadvantage that combines 17 US Census block indicators of poverty, education, housing, and employment (Singh Am J Public Health. 2003). ADI scores have been shown to be associated with hospital readmission and mortality in the general population and in chronic diseases, such as diabetes (Kind et al. Ann Intern Med. 2014). However, the ADI has not been used in patients with sickle cell disease (SCD), a group that faces health disparities based on race and socioeconomic status and that has high healthcare utilization, including a 41% readmission rate among young adults (Brousseau et al. JAMA. 2010). We applied the ADI to patients with SCD, hospitalized for vaso-occlusive crisis (VOC). We described patient, disease, and treatment characteristics by high and low ADI scores.