The national burden of inpatient dermatology in adults

Background: Management of inpatient skin disease represents a unique subspecialty within dermatology. Objective: To assess the national burden of inpatient dermatology in adults. Methods: Using the 2014 National Inpatient Sample, we performed a retrospective cohort study of adults hospitalized for dermatologic conditions. Results: In 2014, there were 644,320 weighted hospitalizations principally for skin disease in adults, which cost the health care system $5.04 billion. Overall, skin disease was diagnosed in 1 in 8 hospitalized adults. Dermatologic hospitalizations were associated with a lack of medical insurance (odds ratio [OR], 2.27; 95% confidence interval [CI], 2.20-2.34), residence in a low-income community (OR, 1.10; 95% CI, 1.07-1.13), and small (OR, 1.27; 95% CI, 1.23-1.32) or rural hospitals (OR, 1.38; 95% CI, 1.32-1.44). Racial minorities were less likely to be hospitalized for skin disease than were whites (for blacks: OR, 0.77; 95% CI, 0.75-0.79; for Hispanics: OR, 0.85; 95% CI, 0.83-0.8; for Asians: OR, 0.59; 95% CI, 0.55-0.64). Only 0.47% of patients admitted for skin disease experienced in-hospital mortality; however, mortality rates were high in hospitalizations for cutaneous lymphomas (9.19%) and malignant melanoma (6.54%). Limitations: We could not assess the impact of inpatient dermatology consultations on hospitalization outcomes. Conclusions: Skin disease is highly prevalent among hospitalized patients.