LIMITATIONS
There are several limitations that are worth mentioning. Concerning the HRQOL variable, this data captured the patient’s experience within the past month. While this method was most appropriate for this study design, examining HRQOL over a broader period may depict a deeper understanding of the connection between healthcare utilization and HRQOL.
In referencing the inclusion/exclusion criteria, this study excluded patients with comorbid developmental disabilities, but did not exclude patients with comorbid physical illnesses. The PedsQL 3.0 assisted with gathering data related to SCD as opposed to using a generic scale; however, comorbid diseases such as diabetes may also influence symptoms of SCD that contributes to the frequency of healthcare use. Excluding or controlling for this data may improve the power of this type of study.
While the number of participants included in this study mirrors previous research in this area, the number of patients in the current study is hardly generalizable. The results highlight concerns surrounding healthcare usage and patient wellbeing; however, these results should be interpreted with caution. Perhaps a multicenter, longitudinal study design would further substantiate research in this area.