Ayyalaraju R Sowjanya, Finlay Andrew Y, Dykes Peter J, Trent Jennifer T, Kirsner Robert S, Kerdel Francisco A
Department of Dermatology at University of Wales College of Medicine, Heath Park, United Kingdom.
J Am Acad Dermatol. 2003 Aug;49(2):249-54. doi: 10.1067/s0190-9622(03)00897-1.
Financial and managerial constraints have resulted in the rationalization of dermatology inpatient services in the United Kingdom and the United States. Therapeutic regimes may vary locally, regionally, and internationally but the clinical outcome of treatment remains the same.
We studied 2 inpatient units: the University of Wales College of Medicine, Cardiff, United Kingdom, and the University of Miami School of Medicine, Miami, Florida, to compare the use and effectiveness of the service provided.
Data were collected prospectively from inpatients during a 12-month period. The Dermatology Life Quality Index was administered on admission and after discharge. Data were recorded about the diagnosis, duration of admission, and referring dermatologist.
In all, 295 patients (Cardiff, UK) and 366 patients (Miami, Fla) participated. The average duration of admission in Miami was 6.7 days compared with 14.2 (P <.0001) in Cardiff. In Miami, the most common reasons necessitating admission were extensive disease (54%), the patient being unwell (18%), photophoresis (14%), outpatient treatment failure (8%), and acute deterioration of disease (4%). In Cardiff, the common reasons were acute deterioration (35%), extensive disease (28%), outpatient treatment failure (22%), and liver biopsy (4%). The most common diagnoses in Cardiff were psoriasis (31%) and eczema (26%). In contrast, the most common diagnoses in Miami, were psoriasis (19%), leg ulcers (17%), and mycosis fungoides (14%). The mean Dermatology Life Quality Index value for all patients decreased after admission in Cardiff (14.9-8.2, P <.0001) and Miami (12.0-8.5, P <.0001).
Despite the differences in the 2 health care systems, inpatient therapy remains an important and effective therapeutic option in the United States and the United Kingdom.
经济和管理方面的限制导致英国和美国皮肤科住院服务趋于合理化。治疗方案可能因地区和国际的不同而有所差异，但治疗的临床结果是相同的。
我们研究了两个住院科室：英国加的夫的威尔士大学医学院和美国佛罗里达州迈阿密的迈阿密大学医学院，以比较所提供服务的使用情况和有效性。
前瞻性收集12个月期间住院患者的数据。在入院时和出院后使用皮肤病生活质量指数进行评估。记录有关诊断、住院时间和转诊皮肤科医生的数据。
共有295名患者（英国加的夫）和366名患者（美国佛罗里达州迈阿密）参与。迈阿密的平均住院时间为6.7天，而加的夫为14.2天（P<.0001）。在迈阿密，需要住院的最常见原因是广泛疾病（54%）、患者身体不适（18%）、光化学疗法（14%）、门诊治疗失败（8%）和疾病急性恶化（4%）。在加的夫，常见原因是疾病急性恶化（35%）、广泛疾病（28%）、门诊治疗失败（22%）和肝活检（4%）。加的夫最常见的诊断是银屑病（31%）和湿疹（26%）。相比之下，迈阿密最常见的诊断是银屑病（19%）、腿部溃疡（17%）和蕈样肉芽肿（14%）。加的夫所有患者入院后的皮肤病生活质量指数平均值得分下降（14.9 - 8.2，P<.0001），迈阿密也是如此（12.0 - 8.5，P<.0001）。
尽管两个医疗系统存在差异，但住院治疗在美国和英国仍然是一种重要且有效的治疗选择。
