Abstract:
IMPORTANCE:Hidradenitis suppurativa (HS) is a chronic cutaneous disease with acutely painful flares that require appropriate and timely treatment. OBJECTIVE:To assess how individuals with HS utilize medical care, especially emergency department (ED) care, a high-cost setting, and to describe the health care costs for this group. DESIGN, SETTING, AND PARTICIPANTS:Cohort cost-identification study of 150 493 individuals with claims from the MarketScan medical claims database. Patients with claims for HS and psoriasis (16 736 and 110 266, respectively) and a control group with neither condition (23 491) during the study period, January 2008 to December 2010, were included. EXPOSURES:An HS cohort was formed from all the patients who had 2 or more claims for HS (International Classification of Diseases, Ninth Revision [ICD-9] code 705.83) during the 3-year period. A psoriasis cohort was used as a comparison group, since it is another chronic inflammatory condition with prominent skin findings. This group included randomly selected patients who had 2 or more claims for psoriasis (ICD-9 code 696.1) during the 3-year period. A second control group included randomly selected patients who had no claims for either condition during the 3-year period. From these cohorts only patients that were continuously enrolled for the 3-year period were included. MAIN OUTCOMES AND MEASURES:Health care utilization measures including inpatient length of stay, emergency department and outpatient visits, and number of days supplied of prescription medication were investigated. Cost variables were also investigated and included inpatient, outpatient, emergency department, prescription drug, and total all-cause health care expenditures, which were adjusted for inflation and reported in 2010 US dollars. RESULTS:The largest component of the total 3-year cost for the HS group was inpatient cost (37.4%). In contrast, for the psoriasis group this was drug costs (46.5%) and for the control group, inpatient costs (40.9%). The proportion of people who were hospitalized in the HS cohort (15.8%) was higher than the psoriasis (10.8%) or control (8.6%) groups (P < .001). The proportion of patients who used the ED over the 3-year period was higher in the HS cohort (27.1%) than the psoriasis (17.4%) or control groups (17.2%) (P < .001). Similarly, the mean (SD) 3-year ED cost for the HS group was $2002 ($6632) and was higher than both comparison groups (P < .001). After adjustment for age, sex, and comorbidities, ED utilization remained higher in the HS group compared with the control (P < .001) and psoriasis (P = .02) cohorts. CONCLUSIONS AND RELEVANCE:Hidradenitis suppurativa affects a younger, predominantly female population of patients. High-cost settings, such as ED and inpatient care, are used more frequently for patients with HS. Both patients and clinicians should be aware of this finding, and further research is needed to investigate the impact of health care utilization on patient outcomes.
journal_name
JAMA Dermatoljournal_title
JAMA dermatologyauthors
Kirby JS,Miller JJ,Adams DR,Leslie Ddoi
10.1001/jamadermatol.2014.691subject
Has Abstractpub_date
2014-09-01 00:00:00pages
937-44issue
9eissn
2168-6068issn
2168-6084pii
1878305journal_volume
150pub_type
杂志文章相关文献
JAMA Dermatology文献大全abstract:Importance:Psoriasis is associated with an increased risk of cardiovascular diseases. Subclinical atherosclerosis in patients with psoriasis has not been compared with other conditions associated with increased cardiovascular risk and more rigorous cardiovascular disease screening, such as type 2 diabetes. Objective:T...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2016.2907
更新日期:2016-11-01 00:00:00
abstract:Importance:Breslow thickness is a 1-dimensional surrogate prognostic feature for tumor size, yet tissue sections have 2 dimensions. Therefore, a 2-dimensional feature, calculated tumor area (CTA), was devised. Objective:To determine CTA precision and prognostic value. Design, Setting, and Participants:This retrospect...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2019.0621
更新日期:2019-06-26 00:00:00
abstract:IMPORTANCE:Approximately 10% to 25% of patients treated with BRAF inhibitors develop cutaneous squamous cell carcinoma (SCC), but the mechanism responsible has not yet been determined. We report what we believe to be the first case in which Merkel cell polyomavirus (MCPyV) and human papillomavirus subtype 17 (HPV-17) w...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.2023
更新日期:2013-03-01 00:00:00
abstract:IMPORTANCE:Lichen sclerosus (LS) is an uncommon chronic inflammatory disease that most commonly affects anogenital skin of postmenopausal women. It typically manifests as atrophic white plaques, which may be accompanied by purpura or fissuring. Rarely, LS has been observed to affect mucosal tissues in the mouth and the...
journal_title:JAMA dermatology
pub_type: 杂志文章,评审
doi:10.1001/jamadermatol.2013.4885
更新日期:2013-10-01 00:00:00
abstract:Importance:Controversy persists regarding the appropriate management of incompletely excised, biopsy-proven, mild and moderate dysplastic nevi (DN). Objective:To determine long-term risk of associated melanoma in biopsied mild or moderate DN with positive histologic margins that were clinically observed vs reexcised w...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.2869
更新日期:2016-12-01 00:00:00
abstract:Importance:Pubic hair grooming is a common practice that can lead to injury and morbidity. Objective:To identify demographic and behavioral risk factors associated with pubic hair grooming-related injuries to characterize individuals with high risk of injury and develop recommendations for safe grooming practices. De...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.2815
更新日期:2017-11-01 00:00:00
abstract:Importance:Despite the growing popularity of cosmetic procedures, the sociocultural and quality-of-life factors that motivate patients to undergo such procedures are not well understood. Objective:To estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures. Des...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2018.2357
更新日期:2018-10-01 00:00:00
abstract:Importance:In the US, incidence of and mortality due to anal carcinoma are rising faster than for most other cancers. Identifying populations who have a higher risk of developing anal cancers is critical to target preventive interventions. Objective:To assess the risk of developing anal carcinoma in adults living with...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2020.5252
更新日期:2021-01-13 00:00:00
abstract:Importance:Erythropoietic protoporphyria (EPP) is a rare hereditary disease of heme biosynthesis that manifests as severe photosensitivity and hepatotoxicity. There have been no effective treatments to date. Cimetidine has been shown to inhibit heme biosynthesis and results in symptomatic improvement in patients with a...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.2303
更新日期:2016-11-01 00:00:00
abstract:IMPORTANCE:Solid-organ transplant recipients (OTRs) are at an increased risk for skin cancer. Prior studies have demonstrated a reduced incidence of skin cancer in renal OTRs treated with sirolimus. However, little information exists on the use of sirolimus for the prevention of skin cancer in nonrenal OTRs or those al...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2015.5548
更新日期:2016-05-01 00:00:00
abstract:Importance:Incidence rates of skin cancer are increasing globally, and the correct classification of skin lesions (SLs) into benign and malignant tissue remains a continuous challenge. A collective intelligence approach to skin cancer detection may improve accuracy. Objective:To evaluate the performance of 2 well-know...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.3149
更新日期:2015-12-01 00:00:00
abstract:IMPORTANCE:Treatment outcomes depend on adherence to the prescribed regimen. Primary nonadherence refers to not obtaining and starting to take a prescribed medication. The frequency of primary nonadherence to acne treatment has not been well characterized. The complexity of multidrug acne regimens may add to this probl...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.5254
更新日期:2015-06-01 00:00:00
abstract:Importance:Skin cancer, the most common cancer in the United States, is highly associated with outdoor and indoor tanning behaviors. Although indoor tanning has been suggested to be more common among sexual minority (self-reported as homosexual, gay, or bisexual) men compared with heterosexual men, whether rates of ski...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.3126
更新日期:2015-12-01 00:00:00
abstract:Clinical Question:Which treatments have been shown to be effective in randomized clinical trials (RCTs) for hidradenitis suppurativa (HS) in adults? Bottom Line:There is high-quality evidence of benefit from adalimumab given weekly, while every other week dosing is ineffective, with reductions in Dermatology Life Qual...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.0432
更新日期:2017-05-01 00:00:00
abstract:IMPORTANCE:Nevi are among the strongest risk factors for melanoma. However, little is known about the association of many total nevi (TN) or atypical nevi (AN) with tumor thickness. OBJECTIVES:To examine the association between age and the number of TN and AN and to explore whether there was a relationship between TN ...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2016.0027
更新日期:2016-04-01 00:00:00
abstract:Importance:The risk for skin cancer has been well characterized in white organ transplant recipients (OTRs); however, most patients on the waiting list for organ transplant in the United States are nonwhite. Little is known about cutaneous disease and skin cancer risk in this OTR population. Objective:To compare the i...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.0045
更新日期:2017-06-01 00:00:00
abstract:IMPORTANCE:Recent data demonstrated somatic mutations in GJB2 that were present in affected porokeratotic eccrine ostial and dermal duct nevus (PEODDN) tissue but absent in unaffected skin. Recognizing that PEODDN lesions can also appear in individuals with keratitis-ichthyosis-deafness syndrome and finding somatic mut...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2014.5069
更新日期:2015-06-01 00:00:00
abstract:IMPORTANCE:While monotherapy with biologic agents is effective for many patients with psoriasis, some patients require combination therapy. Evidence-based recommendations on combination therapy provide guidance for treating appropriately selected patients with psoriasis. OBJECTIVE:To make evidence-based, best-practice...
journal_title:JAMA dermatology
pub_type: 杂志文章,评审
doi:10.1001/jamadermatol.2014.3456
更新日期:2015-04-01 00:00:00
abstract:Importance:Population-level disease metrics are critical to guide the distribution of resources and implementation of public health initiatives. Internet search data reflect population interest in health topics and may be an alternative metric of disease characteristics when traditional sources are lacking, such as in ...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.1870
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To compare the prevalence and incidence of type 2 diabetes mellitus between patients with psoriasis and those without psoriasis. DATA SOURCES:MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews between January 1, 1980, and January 1, 2012. STUDY SELECTION:Observational (cohort, case-control, and cr...
journal_title:JAMA dermatology
pub_type: 杂志文章,meta分析,评审
doi:10.1001/2013.jamadermatol.406
更新日期:2013-01-01 00:00:00
abstract:Importance:Persistent radiation-induced alopecia (pRIA) and its management have not been systematically described. Objective:To characterize pRIA in patients with primary central nervous system (CNS) tumors or head and neck sarcoma. Design, Setting, and Participants:A retrospective cohort study of patients from Janua...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2020.2127
更新日期:2020-09-01 00:00:00
abstract:Importance:Pyoderma gangrenosum and necrotizing Sweet syndrome are diagnostically challenging variants of neutrophilic dermatosis that can clinically mimic the cutaneous and systemic features of necrotizing fasciitis. Improved characterization of these rare variants is needed, as improper diagnosis may lead to inapprop...
journal_title:JAMA dermatology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamadermatol.2018.3890
更新日期:2019-01-01 00:00:00
abstract:Importance:Concerns have been raised about the use of radiotherapy (RT) by dermatologists. Little is known about temporal trends in payment for RT among dermatologists. Objective:To characterize changes in RT use and payment among dermatologists treating patients enrolled in Medicare. Design, Setting, and Participant...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2020.4931
更新日期:2020-12-23 00:00:00
abstract:IMPORTANCE:Basal cell carcinomas (BCCs) are diagnosed by clinical evaluation, which can include dermoscopic evaluation, biopsy, and histopathologic examination. Recent translation of multiphoton microscopy (MPM) to clinical practice raises the possibility of noninvasive, label-free in vivo imaging of BCCs that could re...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2015.0453
更新日期:2015-10-01 00:00:00
abstract:Importance:Melanoma treatment has been revolutionized with the development of immune-based therapies that offer durable clinical responses in a subset of patients. Clinical outcomes after treatment by immunotherapy can be influenced by the host's immune system. The immune system is modified with age by age-related immu...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.4584
更新日期:2018-01-01 00:00:00
abstract:Importance:Patients with vascular malformations (VAMs) and vascular overgrowth syndromes have lower health-related quality of life (HRQoL) attributable to social stigmatization, poor mental health, severity, and pain. However, the factors that contribute to this decreased HRQoL are not clear. Objective:To perform a sy...
journal_title:JAMA dermatology
pub_type: 杂志文章,meta分析
doi:10.1001/jamadermatol.2018.0002
更新日期:2018-06-01 00:00:00
abstract:IMPORTANCE:Omalizumab has emerged as a novel and effective treatment option for patients with antihistamine-resistant chronic urticaria. It is unclear whether patients with recurrent urticaria symptoms after discontinuation of omalizumab treatment can benefit from retreatment. OBJECTIVE:To assess the response of patie...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2013.8705
更新日期:2014-03-01 00:00:00
abstract:Importance:Use of systemic therapies for moderate to severe psoriasis in children is increasing, but comparative data on their use and toxicities are limited. Objective:To assess patterns of use and relative risks of systemic agents for moderate to severe psoriasis in children. Design, Setting, and Participants:A ret...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.3029
更新日期:2017-11-01 00:00:00
abstract:Importance:Erythromelalgia is a clinical diagnosis based on intermittent warmth, erythema, and pain in the distal extremities. One problem facing physicians is how to objectively test for this disease. Given that other painful conditions of the distal extremities (ie, neuropathy related to human immunodeficiency virus,...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2016.4404
更新日期:2017-02-01 00:00:00
abstract:Importance:Because moisturizer use is critical for the prevention and treatment of numerous dermatological conditions, patients frequently request product recommendations from dermatologists. Objective:To determine the product performance characteristics and ingredients of best-selling moisturizers. Design and Settin...
journal_title:JAMA dermatology
pub_type: 杂志文章
doi:10.1001/jamadermatol.2017.3046
更新日期:2017-11-01 00:00:00