Title

Predictors of hospital readmission in United States adults with psoriasis

Document Type

Journal Article

Publication Date

4-1-2020

Journal

Journal of the American Academy of Dermatology

Volume

82

Issue

4

DOI

10.1016/j.jaad.2019.10.051

Keywords

comorbidity; emergency; epidemiology; health services; hospitalization; psoriasis; readmission

Abstract

© 2019 American Academy of Dermatology, Inc. 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.

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