One of the Healthy People 2010 objectives (16.21) is to reduce hospitalization rates for life-threatening sepsis among young children with sickle cell disease. Healthy People 2010 cites the National Hospital Discharge Survey as a potential data source for measuring progress toward this objective. In 1997, Davis et al. published results of a study of baseline data from the National Hospital Discharge Survey. Individual state hospital discharge files have also provided data regarding types and costs of hospitalizations among young children with sickle cell disease. Other data sources have provided epidemiologic data to evaluate sickle cell mortality trends. In a study of U.S. death certificates for 1968-1992, mortality among black children aged 1-4 years who had sickle cell disease declined significantly. This trend occurred at the same time as the establishment of newborn screening programs, more comprehensive care and parental education, widespread acceptance of penicillin prophylaxis, and new vaccinations. Findings from newborn screening follow-up studies, based on state health department databases, have also indicated recent declines in mortality rates among young children with sickle cell disease. These data sources all have inherent limitations, but the primary strength of population-based studies is to provide "real world" validation of the effectiveness of interventions to prevent complications from sickle cell disease.
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