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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 6 février 2020
Doi : 10.1016/j.jaad.2019.10.051
accepted : 22 October 2019
Predictors of hospital readmission in United States adults with psoriasis
 

Brian T. Cheng, BA a, Jonathan I. Silverberg, MD, PhD, MPH a, b, c,
a Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 
b Department of Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 
c Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois 

Correspondence to: Jonathan I. Silverberg, MD, PhD, MPH, Department of Dermatology, The George Washington University School of Medicine, Ste 2B-430, 2150 Pennsylvania Ave, Washington, DC 20037.Department of DermatologyThe George Washington University School of MedicineSte 2B-4302150 Pennsylvania AveWashingtonDC20037
Abstract
Background

Previous studies showed a large inpatient burden of psoriasis in the United States. Less is known about the hospital readmission for psoriasis.

Objectives

To determine the patterns and predictors of hospital readmission rates for psoriasis.

Methods

We analyzed data from the 2012-2014 Nationwide Readmissions Database, a representative sample of hospital readmissions in the United States.

Results

Among 2606 admissions for psoriasis, 216 had ≥1 readmissions for psoriasis (prevalence [95% confidence interval]: 8.3% [6.6%-10.0%]) and 918 for all-causes (35.2% [32.2%-38.3%]). The mean annual cost of first readmission for any reason was $3,500,141, with $8,357,961 for subsequent readmissions. In multivariable regression models, readmission for psoriasis was associated with ≥6 day-long index hospitalization (adjusted hazard ratio [95% confidence interval]: 1.82 [1.06-3.12]), teaching hospital (1.93 [1.13-3.31]), comorbid skin infection (2.13 [1.11-4.08]), and hospitalization in the autumn (4.51 [2.54-8.00]), but inversely associated with other infections (0.49 [0.26-0.92]). Readmissions for psoriasis increased from 2012 to 2014 (1.93 [1.26-2.93]).

Limitations

No data on psoriasis characteristics.

Conclusion

Inpatients with psoriasis had high rates of readmission overall but low rates of readmission for psoriasis per se. A subset of psoriasis patients was hospitalized repeatedly and responsible for most inpatients costs. Future interventions are needed to lower readmission rates among psoriasis patients.

The full text of this article is available in PDF format.

Key words : comorbidity, emergency, epidemiology, health services, hospitalization, psoriasis, readmission

Abbreviations used : CI, HR, ICD-9-CM, IQR, NRD, OR, US



 Funding sources: This publication was made possible with support from the Dermatology Foundation, which was not involved in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
 Conflicts of interest: None disclosed.
 IRB approval status: The Northwestern University Institutional Review Board approved the study.
 Reprints not available from the authors.



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