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成人住院皮肤科的国家负担。

The national burden of inpatient dermatology in adults.

机构信息

George Washington University School of Medicine and Health Sciences, Washington, DC.

Department of Economics, Georgetown University, Washington, DC.

出版信息

J Am Acad Dermatol. 2019 Feb;80(2):425-432. doi: 10.1016/j.jaad.2018.06.070. Epub 2018 Dec 13.

Abstract

BACKGROUND

Management of inpatient skin disease represents a unique subspecialty within dermatology.

OBJECTIVE

To assess the national burden of inpatient dermatology in adults.

METHODS

Using the 2014 National Inpatient Sample, we performed a retrospective cohort study of adults hospitalized for dermatologic conditions.

RESULTS

In 2014, there were 644,320 weighted hospitalizations principally for skin disease in adults, which cost the health care system $5.04 billion. Overall, skin disease was diagnosed in 1 in 8 hospitalized adults. Dermatologic hospitalizations were associated with a lack of medical insurance (odds ratio [OR], 2.27; 95% confidence interval [CI], 2.20-2.34), residence in a low-income community (OR, 1.10; 95% CI, 1.07-1.13), and small (OR, 1.27; 95% CI, 1.23-1.32) or rural hospitals (OR, 1.38; 95% CI, 1.32-1.44). Racial minorities were less likely to be hospitalized for skin disease than were whites (for blacks: OR, 0.77; 95% CI, 0.75-0.79; for Hispanics: OR, 0.85; 95% CI, 0.83-0.8; for Asians: OR, 0.59; 95% CI, 0.55-0.64). Only 0.47% of patients admitted for skin disease experienced in-hospital mortality; however, mortality rates were high in hospitalizations for cutaneous lymphomas (9.19%) and malignant melanoma (6.54%).

LIMITATIONS

We could not assess the impact of inpatient dermatology consultations on hospitalization outcomes.

CONCLUSIONS

Skin disease is highly prevalent among hospitalized patients.

摘要

背景

住院皮肤疾病的管理是皮肤科中的一个独特亚专科。

目的

评估成人住院皮肤科的全国负担。

方法

使用 2014 年全国住院患者样本,我们对因皮肤疾病住院的成年人进行了回顾性队列研究。

结果

2014 年,有 644320 例成人因皮肤疾病住院,这给医疗保健系统带来了 50.4 亿美元的费用。总体而言,每 8 名住院成年人中就有 1 人被诊断患有皮肤病。皮肤科住院与缺乏医疗保险(比值比[OR],2.27;95%置信区间[CI],2.20-2.34)、居住在低收入社区(OR,1.10;95%CI,1.07-1.13)以及小型(OR,1.27;95%CI,1.23-1.32)或农村医院(OR,1.38;95%CI,1.32-1.44)有关。少数族裔患者因皮肤疾病住院的可能性低于白人(黑人:OR,0.77;95%CI,0.75-0.79;西班牙裔:OR,0.85;95%CI,0.83-0.80;亚洲人:OR,0.59;95%CI,0.55-0.64)。仅有 0.47%因皮肤疾病住院的患者发生院内死亡;然而,皮肤淋巴瘤(9.19%)和恶性黑色素瘤(6.54%)住院患者的死亡率较高。

局限性

我们无法评估住院皮肤科会诊对住院治疗结果的影响。

结论

皮肤疾病在住院患者中普遍存在。

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