Dermatology-specific and all-cause 30-day and calendar-year readmissions and costs for dermatologic diseases from 2010 to 2014

Abstract

Background: Readmissions for skin disease, particularly for the same diagnosis and over time, have not been well studied.

Objective: To characterize hospital readmissions for skin disease.

Methods: A cross-sectional observational study examined the Nationwide Readmissions Database from 2010 to 2014, a national sample of hospital discharges in the United States.

Results: 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.

Limitations: This study is a broad description of hospitalizations for skin disease. Conclusions for individual diseases are not intended.

Conclusion: 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.

Keywords: Nationwide Readmissions Database; cost of care; dermatology hospitalizations; dermatology readmissions; epidemiology; hospital readmissions; inpatient dermatology.

Figure 1.

Readmission frequencies, rates, and costs over time from 2010 through 2014. (A) Yearly readmission frequencies from 2010–2014. (B) Readmission rates from 2010–2014. (C) Total cost of calendar year same cause readmissions from 2010–2014, plotted on log-linear scale. (D) Mean cost per calendar year same cause readmission from 2010–2014. Abbreviations: CY, calendar year; SLE, systemic lupus erythematosus; TMA, thrombotic microangiopathy