Department of Dermatology, Weill Cornell Medicine, New York, New York.
Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
J Am Acad Dermatol. 2019 Sep;81(3):740-748. doi: 10.1016/j.jaad.2019.05.023. Epub 2019 May 15.
Readmissions for skin disease, particularly for the same diagnosis and over time, have not been well studied.
To characterize hospital readmissions for skin disease.
A cross-sectional observational study examined the Nationwide Readmissions Database from 2010 to 2014, a national sample of hospital discharges in the United States.
Of the patients in 3,602,599 dermatologic hospitalizations from 2010 to 2014, 9.8% were readmitted for any cause, 3.3% were admitted for the same diagnosis within 30 days, and 7.8% were readmitted for the same diagnosis within the calendar year (CY). The cost of all CY same-cause readmissions was $508 million per year. Mycosis fungoides had the highest 30-day all-cause readmission rate (32%), vascular hamartomas and dermatomyositis had the highest 30-day same-cause readmission rates (21% and 18%, respectively), and dermatomyositis and systemic lupus erythematosus had the highest CY same-cause readmission rates (31% and 24%, respectively). Readmission rates stayed stable from 2010 to 2014. Readmission for the same diagnosis was strongly associated with Medicaid and morbid obesity.
This study is a broad description of hospitalizations for skin disease. Conclusions for individual diseases are not intended.
The rates and costs of readmissions for skin diseases remained high from 2010 to 2014. This study identifies diseases associated with high risk of hospital readmission, but disease-specific studies are needed. The diseases and risk factors presented should guide additional studies focused on strategies to reduce readmissions in specific skin diseases.
皮肤疾病的再入院率,尤其是针对同一诊断且随时间推移的再入院率,尚未得到充分研究。
描述皮肤疾病的医院再入院情况。
采用横断面观察性研究方法,对 2010 年至 2014 年全美范围内的国家再入院数据库(美国医院出院患者的全国性样本)进行了研究。
在 2010 年至 2014 年的 3602599 例皮肤科住院患者中,9.8%因任何原因再次入院,3.3%在 30 天内因同一诊断再次入院,7.8%在当年内(CY)因同一诊断再次入院。所有 CY 同一病因再入院的费用为每年 5.08 亿美元。蕈样真菌病的 30 天全因再入院率最高(32%),血管错构瘤和皮肌炎的 30 天同一病因再入院率最高(分别为 21%和 18%),皮肌炎和系统性红斑狼疮的 CY 同一病因再入院率最高(分别为 31%和 24%)。2010 年至 2014 年,再入院率保持稳定。同一诊断的再入院与医疗补助和病态肥胖密切相关。
本研究对皮肤疾病住院情况进行了广泛描述,并不针对个别疾病下结论。
2010 年至 2014 年,皮肤疾病的再入院率和费用仍然居高不下。本研究确定了与高住院再入院风险相关的疾病,但需要进行疾病特异性研究。所提出的疾病和危险因素应指导进一步研究,以制定针对特定皮肤疾病的减少再入院策略。