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Hospital readmissions among patients with skin disease: A retrospective cohort study

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Background: Hospital readmissions represent a potential target for reducing unnecessary health care expenditures; however, readmissions following dermatology hospitalizations remain poorly characterized. Objective: To assess the frequency and demographics of readmissions… Click to show full abstract

Background: Hospital readmissions represent a potential target for reducing unnecessary health care expenditures; however, readmissions following dermatology hospitalizations remain poorly characterized. Objective: To assess the frequency and demographics of readmissions for skin disease. Methods: We performed a retrospective cohort study of dermatology hospitalizations by using the 2014 Nationwide Readmissions Database. Results: Readmissions following dermatologic hospitalizations cost the American health care system $1.05 billion in 2014. The 30‐day rate of all‐cause readmission following the 647,251 weighted index admissions for skin disease was 12.63%. Readmission was most common following hospitalizations for cutaneous lymphomas (39.63%), connective tissue disorders (26.28%), and cutaneous congenital abnormalities (23.86%). Predictors of readmission included public insurance with Medicaid (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.53‐1.70) or Medicare (OR, 1.55; 95% CI, 1.48‐1.62), residence in a low‐income community (OR, 1.14; 95% CI, 1.09‐1.20), an increased number of chronic conditions (OR, 4.46; 95% CI, 4.15‐4.79), and a large hospital (OR, 1.10; 95% CI, 1.05‐1.16). Urban (OR, 0.90; 95% CI, 0.87‐0.94) and rural (OR, 0.78; 95% CI, 0.73‐0.82) nonteaching hospitals were protective against readmissions from skin disease. Limitations: We were unable to assess the impact of inpatient dermatology consultations on hospital readmission rates. Conclusions: There are significant health care and demographic disparities in readmissions for skin disease.

Keywords: dermatology; skin disease; retrospective cohort; hospital readmissions; cohort study

Journal Title: Journal of the American Academy of Dermatology
Year Published: 2018

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