Hospital readmissions among patients with skin disease: A retrospective cohort study

Abstract

Background: Hospital readmissions represent a potential target for reducing unnecessary health care expenditures; however, readmissions following dermatology hospitalizations remain poorly characterized.

Objective: To assess the frequency and demographics of readmissions for skin disease.

Methods: We performed a retrospective cohort study of dermatology hospitalizations by using the 2014 Nationwide Readmissions Database.

Results: Readmissions following dermatologic hospitalizations cost the American health care system $1.05 billion in 2014. The 30-day rate of all-cause readmission following the 647,251 weighted index admissions for skin disease was 12.63%. Readmission was most common following hospitalizations for cutaneous lymphomas (39.63%), connective tissue disorders (26.28%), and cutaneous congenital abnormalities (23.86%). Predictors of readmission included public insurance with Medicaid (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.53-1.70) or Medicare (OR, 1.55; 95% CI, 1.48-1.62), residence in a low-income community (OR, 1.14; 95% CI, 1.09-1.20), an increased number of chronic conditions (OR, 4.46; 95% CI, 4.15-4.79), and a large hospital (OR, 1.10; 95% CI, 1.05-1.16). Urban (OR, 0.90; 95% CI, 0.87-0.94) and rural (OR, 0.78; 95% CI, 0.73-0.82) nonteaching hospitals were protective against readmissions from skin disease.

Limitations: We were unable to assess the impact of inpatient dermatology consultations on hospital readmission rates.

Conclusions: There are significant health care and demographic disparities in readmissions for skin disease.

Keywords: Healthcare Cost and Utilization Project; Nationwide Readmission Database; dermatology hospitalizations; health care expenditures; hospital readmissions; inpatient dermatology.