The following article is a part of conference coverage from the 2022 American Academy of Dermatology Annual Meeting , held live from March 25 through March 29 in Boston, Massachusetts. The team at Dermatology Advisor will be reporting on the latest news and research conducted by leading experts in dermatology. Check back for more from the 2022 AAD Annual Meeting .

 

Inpatient dermatology services are associated with risk-adjusted improvement in mortality and readmission rates for patients who are admitted with skin diseases, according to research presented at the 2022 Annual Meeting of the American Academy of Dermatology (AAD), held from March 25 to 29, 2022 in Boston, Massachusetts.


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Investigators used national Medicare claims data to compare risk-adjusted mortality, readmissions, length of stay (LOS), and costs at Society of Dermatology Hospitalists (SODH) hospitals compared with nonmember hospitals.

Data were obtained from the CMS Inpatient Standard Analytic File and Master Beneficiary Summary File (2016-2018) and included encounter level claims from Medicare fee-for-service (FFS) and all dermatology-specific discharges (n=30,900) at US teaching hospitals.

Mixed effect logistic regression analysis was used to adjust for Elixhauser comorbidity burden, age, sex, race, Medicare severity diagnosis-related groups, dual-enrollment in Medicaid, hospital bed size, geographic region, and hospital ownership.

The outcomes were 30-day mortality, 30-day readmission, LOS, and costs.

Treatment at SODH hospitals was associated with significantly lower 30-day mortality (odds ratio [OR] 0.76; 95% CI, 0.60, 0.97; P =.03) and 30-day readmissions (OR 0.88; 95% CI, 0.78, 1.00; P =.05), after risk adjustment.

The average cost of hospitalization was $850 higher (95% CI, $228, $931; P <.0001) at SODH hospitals. No differences were found in LOS (P =.31) between the 2 hospital groups.

Study limitations include analysis based on retrospective claims data, a Medicare FFS population, and SODH membership as proxy.

“The mechanisms driving lower mortality and readmissions at SODH hospitals remain unclear,” noted the researchers, although they suggested that increased diagnostic and therapeutic accuracy and higher rates of outpatient dermatology follow-ups may be responsible.

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Puri P, Pollock BD, Yousif M, et al. Inpatient dermatology services are associated with lower mortality and readmissions rates: a nationally representative analysis of 30,900 hospitalizations. Presented at: American Academy of Dermatology (AAD) 2022 Annual Meeting; March 25-29, 2022. Poster 33931.

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