FROM THE JOURNAL OF INVESTIGATIVE DERMATOLOGY
Inpatient care for atopic dermatitis in the U.S. totaled almost $128 million between 2002 and 2012, indicating a rising financial burden, according to a study funded by the Agency for Healthcare Research and Quality (AHRQ).
Cost of care averaged $8.3 million per year for adults and $3.3 million per year for children, with per-day costs for adult care increasing from $3,200 in 2002 to $3,783 in 2012 and per-day costs for pediatric care increasing from $2,430 to $2,914 in the same period, according to Shanthi Narla, a doctoral research fellow at Northwestern University, Chicago, and her colleagues (J Invest Dermatol. 2017 Mar 1. doi: 10.1016/j.jid.2017.02.975 )
In a retrospective study of around 87 million patient records from the 2002-2012 National Inpatient Sample, Ms. Narla and her colleagues found prevalence of atopic dermatitis (AD) or eczema hospitalizations to be 2.4 and 5.6 times higher than the prevalence for psoriasis and pemphigus, respectively.
Growth in hospitalizations was seen especially in adult AD patients, which rose from 58 million to 76 million over the decade.
Despite such high comparative rates of hospitalization, most adult (80%) and child (97%) AD patients had a shorter average length of stay than those without AD (adults: 2.7 vs. 3.5 days; children: 2.4 vs. 2.7 days; P = .0004),
Growing prevalence of AD hospitalization contributed to the larger financial burden for AD patients, compared with psoriasis and pemphigus, the researchers noted, considering length of stay per AD hospitalization averaged 62.5% and 50% shorter than those for pemphigus or psoriasis.
“The acute signs and symptoms of [AD or eczema]… erythema, oozing/weeping, scaling and pruritus, may resolve faster with optimized treatment than vesicobullae and erosions in pemphigus or ‘lakes of pus’ and skin sloughing in generalized pustular psoriasis,” they wrote.
Additionally, hospitalization costs for AD were 60% and 33% of the cost per psoriasis and pemphigus hospitalizations, respectively, according to Ms. Narla and her colleagues.
The researchers said they were concerned that the prevalence of AD, and subsequently the inpatient financial burden, will continue to increase if left unchecked.
“Prevalences and costs of hospitalization for AD significantly increased during the study period without plateauing, indicating that the total cost of inpatient care for AD may continue to increase,” the researchers asserted.
This study was limited by a lack of information on the severity of patients’ symptoms, as well as whether a dermatologist or other physician diagnosed the patients and by which criteria.
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