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. 2017 Jun 1;153(6):523-528.
doi: 10.1001/jamadermatol.2016.6130.

Association of Dermatology Consultations With Patient Care Outcomes in Hospitalized Patients With Inflammatory Skin Diseases

Nima Milani-Nejad  1 , Myron Zhang  2 , Benjamin H Kaffenberger  1
Affiliations

Association of Dermatology Consultations With Patient Care Outcomes in Hospitalized Patients With Inflammatory Skin Diseases

Nima Milani-Nejad et al. JAMA Dermatol. .

Abstract

Importance: The value of inpatient dermatology consultations has traditionally been demonstrated with frequency in changes of diagnosis and management; however, the impact of dermatology consultations on metrics such as hospital length of stay and readmission rates remains unknown.

Objective: To determine the association of dermatology consultations with patient care in hospitalized patients using objective values.

Design, setting, and participants: We retrospectively queried the deidentified database of patients hospitalized between January 1, 2012, and December 31, 2014, at a single university medical center. A total of 413 patients with a primary inflammatory skin condition discharge diagnosis and 647 patients with primary inflammatory skin condition admission diagnosis were selected.

Main outcomes and measures: Hospital length of stay and 1-year readmission with inflammatory skin conditions.

Results: The 413 patients with a primary inflammatory skin condition discharge diagnosis were 61.0% female and had a mean (SD) age of 55.1 (16.4) years. The 647 patients with primary inflammatory skin condition admission diagnosis were 50.8% female and had a mean (SD) age of 57.8 (15.9) years. Multivariable modeling showed that dermatology consultations were associated with a reduction of 1-year inflammatory skin condition readmissions among patients who were discharged primarily with an inflammatory skin condition (readmission probability, 0.0025; 95% CI, 0.00020-0.030 with dermatology consult vs 0.026; 95% CI, 0.0065-0.10 without; odds ratio, 0.093; 95% CI, 0.010-0.840; P = .03). No other confounding variable was associated with reduction in readmissions. Multivariable modeling also showed that dermatology consultations were associated with a reduction in the adjusted hospital length of stay by 2.64 days (95% CI, 1.75-3.53 days; P < .001).

Conclusions and relevance: Dermatology consultations were associated with improvements of outcomes among hospitalized patients. The expansion of the role of dermatology consultation services may improve patient care in a cost-effective manner.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Kaffenberger has served as a consultant to Xbiotech, Xoma, Celgene, and Castle Biosciences and has received research funds from Xbiotech, Celgene, Eli Lilly Co, and Biogen. No other disclosures are reported.

Figures

Figure.
Figure.. The Selection Process of the Populations Used for the Models
The deidentified patient database was used for identifying patients with admission or discharge diagnoses of inflammatory skin conditions. The figure indicates the number of patients in each group after removal of patients with missing information and the top 3 diagnoses in each group.
See this image and copyright information in PMC

References

    1. Hu L, Haynes H, Ferrazza D, Kupper T, Qureshi A. Impact of specialist consultations on inpatient admissions for dermatology-specific and related DRGs. J Gen Intern Med. 2013;28(11):1477-1482. - PMC - PubMed
    1. Kirsner RS, Yang DG, Kerdel FA. Dermatologic disease accounts for a large number of hospital admissions annually. J Am Acad Dermatol. 1999;41(6):970-973. - PubMed
    1. Kirsner RS, Yang DG, Kerdel FA. The changing status of inpatient dermatology at American academic dermatology programs. J Am Acad Dermatol. 1999;40(5, pt 1):755-757. - PubMed
    1. Helms AE, Helms SE, Brodell RT. Hospital consultations: time to address an unmet need? J Am Acad Dermatol. 2009;60(2):308-311. - PubMed
    1. Fox LP, Cotliar J, Hughey L, Kroshinsky D, Shinkai K. Hospitalist dermatology. J Am Acad Dermatol. 2009;61(1):153-154. - PubMed

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