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Outpatient utilization patterns for atopic dermatitis in the United States - 11/01/23

Doi : 10.1016/j.jaad.2019.03.021 
Partik Singh, MD, MBA a, Jonathan I. Silverberg, MD, MPH, PhD b,
a University of Rochester Medical Center, Rochester, NY 
b George Washington University School of Medicine and Health Sciences, Washington, DC 

Correspondence to: Jonathan Silverberg, Suite 2B-425, George Washington University, 2150 Pennsylvania Avenue NW, Washington, DC 20037.George Washington UniversitySuite 2B-4252150 Pennsylvania Avenue NWWashingtonDC20037

Abstract

Background

The prevalence and demographics of atopic dermatitis (AD) in the United States have changed. Little is known about trends and determinants of outpatient health care utilization.

Objective

Determine the trends and determinants of outpatient health care utilization for AD in US adults and children.

Methods

Data from the 1993-2015 National Ambulatory Medical Care Survey were analyzed, including data on 110,095 pediatric and 642,140 adult outpatient visits.

Results

AD visits were made predominantly to primary care physicians (PCPs) (768,882 mean visits annually), dermatologists (466,529 mean visits annually), and allergists (18,445 mean visits annually). The frequency of AD visits increased overall from 1996-1999 to 2012-2015 (from 867,649 to 1,950,546 annually [Rao-Scott chi-square P = .02]), particularly among PCPs (from 339,889 to 1,025,739 [P = .02]). The frequency of AD visits to dermatologists decreased (from 446,669 to 371,003 [P = .01]). AD visits to PCPs were most common among children aged 0 to 4 years (32.0%). Adults with comorbid allergic rhinitis or food allergies had greater odds of seeing an allergist. AD visits to PCPs were more likely to be visits due to an acute condition (51.5%), whereas AD visits to dermatologists were more likely to be visits due to a chronic condition (41.2%).

Limitations

AD severity was unavailable.

Conclusions

Outpatient visits for AD in the United States over time increased overall, but those to dermatologists decreased. Dermatologists are most commonly seeing patients whose visit is due to chronic AD, and they should tailor treatment appropriately.

El texto completo de este artículo está disponible en PDF.

Key words : atopic dermatitis, eczema, epidemiology, health services, office, outpatient, utilization

Abbreviations used : AD, CI, NAMCS, ICD-9, PCP, SE


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 Funding sources: Supported by the Dermatology Foundation.
 Conflicts of interest: None disclosed.
 Dr Singh and Dr Silverberg had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis; in addition, both authors take responsibility for the study concept and design, analysis and interpretation of data, drafting and critical revision of the article, and statistical analysis. Dr Silverberg obtained funding and takes responsibility for administrative, technical, and material support, as well as for study supervision.
 Reprints not available from the authors.


© 2019  American Academy of Dermatology, Inc.. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 88 - N° 2

P. 357-363 - février 2023 Regresar al número
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