Faculty Collaboration Database

The inpatient burden of psoriasis in the United States. J Am Acad Dermatol 2016 Jul;75(1):33-41

Date

05/24/2016

Pubmed ID

27210045

DOI

10.1016/j.jaad.2016.03.048

Scopus ID

2-s2.0-84969504528 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

BACKGROUND: Although psoriasis has been linked to increased inpatient cardiovascular mortality, little is known about hospitalization for psoriasis and its inpatient burden in the United States in terms of frequency and cost.

OBJECTIVE: We sought to determine risk factors for hospitalization for psoriasis and quantify cost of care, length of stay, and in-hospital mortality.

METHODS: We conducted a cross-sectional study of the Nationwide Inpatient Sample from 2002 to 2012, containing a representative 20% sample of all US hospitalizations.

RESULTS: Hospitalization for psoriasis was associated with nonwhite race (Asian odds ratio [OR] 2.08, 95% confidence interval [CI] 1.55-2.78; black OR 1.65, 95% CI 1.43-1.89; and multiracial/other OR 1.54, 95% CI 1.13-2.11) and insurance status (Medicare OR 1.33, 95% CI 1.26-1.40; Medicaid OR 1.32, 95% CI 1.25-1.40; and uninsured OR 1.94, 95% CI 1.64-2.30). Mean cost of care was lower for a primary diagnosis of psoriasis in comparison with patients without psoriasis ($7433 ± $254 vs $9956 ± $76; P = .002). Length of stay was significantly prolonged for patients with a primary diagnosis of psoriasis compared with no psoriasis (5.4 ± 0.2 vs 4.6 ± 0.02 days; P < .0001). Mean adjusted in-hospital mortality was 0.4% and 1.8% for a primary or no diagnosis of psoriasis, respectively.

LIMITATIONS: We were unable to look at medication usage and its impact on hospitalization. Information regarding the severity of psoriasis and how this may have affected in-hospital procedures was not available.

CONCLUSION: There are racial and health care disparities in hospitalization for psoriasis, stressing the need for improved access to dermatologic care for all patients.

Author List

Hsu DY, Gordon K, Silverberg JI

Author

Kenneth Brian Gordon MD Chair, Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Databases, Factual
Female
Health Care Costs
Healthcare Disparities
Hospital Mortality
Hospitalization
Humans
Inpatients
Insurance Coverage
Length of Stay
Logistic Models
Male
Middle Aged
Multivariate Analysis
Psoriasis
Risk Assessment
Severity of Illness Index
Socioeconomic Factors
Survival Analysis
United States
Young Adult