Substantial Financial Burden Exists for Emergency Department Visits for Atopic Dermatitis

An increasing financial burden has been associated with hospital emergency department (ED) visits for atopic dermatitis or eczema in the United States, with interventions needed to decrease this rate, according to a cross-sectional study of the 2006 to 2012 National Emergency Department Sample. Results were published in the Journal of the American Academy of Dermatology.

The investigators sought to determine the prevalence of, risk factors associated with, and cost of ED care among patients with atopic dermatitis or eczema in the United States by analyzing a 20% sample of ED visits throughout the country (n=198;102,435).

The researchers reported that the mean annual incidence of ED visits with a primary diagnosis of atopic dermatitis or eczema was 3368.4 to 3553.0 per million persons. From 2006 to 2012, the prevalence of ED visits for atopic dermatitis or eczema increased significantly (survey logistic regression: P <.05). ED visits with vs without a primary diagnosis of atopic dermatitis or eczema were linked with younger patient age, lower household income, having Medicaid or no insurance, and likelihood of occurrence in the summer months.

The geometric mean and total costs associated with ED visits for atopic dermatitis or eczema increased significantly from $369.07 and $127,275,080, respectively, in 2006 to $642.10 and $265,541,084, respectively, in 2012.

A key limitation of the current study was that the National Emergency Department Sample did not include data on severity of atopic dermatitis or eczema, recurrent ED visits, treatments provided, and race/ethnicity of the patients.

The investigators concluded that there is a substantial financial burden being incurred for ED visits related to atopic dermatitis or eczema in the United States. ED visits for atopic dermatitis or eczema seem to be driven by disparities in health care among patients, including having public insurance or no insurance, low household income, and decreased access to outpatient care during weekends and summer months. Interventions designed to improve access to care and to optimize patient care are warranted.

Reference

Kwa L, Silverberg JI. Financial burden of emergency department visits for atopic dermatitis in the United States [published online May 22, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.05.025