Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1763-1770 (doi:10.1542/peds.2005-1611)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow P3Rs: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (3)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Smith, L. A.
Right arrow Articles by Zuckerman, B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Smith, L. A.
Right arrow Articles by Zuckerman, B.
Related Collections
Right arrow Blood

SPECIAL ARTICLE

Sickle Cell Disease: A Question of Equity and Quality

Lauren A. Smith, MD, MPHa, Suzette O. Oyeku, MD, MPHb, Charles Homer, MD, MPHc and Barry Zuckerman, MDa

a Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts
b Division of General Pediatrics, Children’s Hospital Boston, Boston, Massachusetts
c National Initiative for Children’s Healthcare Quality, Boston, Massachusetts

Thirty years ago, the first major federal legislation concerning sickle cell disease treatment was passed, resulting in the development of comprehensive sickle cell centers. We are now at another watershed moment in the treatment of this illness with the passage in October 2004 of the Sickle Cell Treatment Act, designed to substantially expand specialized sickle cell treatment programs. This legislation offers a remarkable opportunity to significantly improve health outcomes for individuals with sickle cell disease if it is implemented with a specific focus on the distinct but related issues of equity and quality. Despite major advances in sickle cell disease treatment that have occurred over the past 3 decades, important gaps exist both in the equity of government and private philanthropic support for research and in the uniform provision of high quality clinical care. This article assesses the current gaps in funding support and in the implementation of improvements in clinical care in order to suggest strategies for making optimal use of the opportunity that the new legislation presents to improve the health of all individuals affected by this disease.

Abbreviations: SCD—sickle cell disease • NIH—National Institutes of Health • RFA—requests for application • NHLBI—National Heart, Lung, and Blood Institute • AHRQ—Agency for Healthcare Research and Quality

Accepted Oct 17, 2005.




This article has been cited by other articles:


Home page
 NEJMHome page
J. M. Perrin and C. J. Homer
The Quality of Children's Health Care Matters -- Time to Pay Attention
N. Engl. J. Med., October 11, 2007; 357(15): 1549 - 1551.
[Full Text] [PDF]

P3Rs:

Read all P3Rs

Exclusive breast feeding and the natural history of sickle cell disease
Khalid Kamal, MD, FAAP
Pediatrics Online, 29 May 2006 [Full text]