Predictors of hospital readmission in United States adults with psoriasis

J Am Acad Dermatol. 2020 Apr;82(4):902-909. doi: 10.1016/j.jaad.2019.10.051. Epub 2019 Oct 31.

Abstract

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.

Keywords: comorbidity; emergency; epidemiology; health services; hospitalization; psoriasis; readmission.

MeSH terms

  • Adolescent
  • Adult
  • Comorbidity
  • Cost of Illness*
  • Databases, Factual / statistics & numerical data
  • Female
  • Forecasting
  • Hospital Costs / statistics & numerical data
  • Hospital Costs / trends
  • Humans
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • Length of Stay / trends
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Readmission / economics
  • Patient Readmission / statistics & numerical data
  • Patient Readmission / trends*
  • Psoriasis / economics*
  • Psoriasis / epidemiology
  • Psoriasis / immunology
  • Psoriasis / therapy
  • Risk Factors
  • Skin Diseases, Infectious / economics
  • Skin Diseases, Infectious / epidemiology*
  • Skin Diseases, Infectious / immunology
  • Skin Diseases, Infectious / therapy
  • Time Factors
  • United States / epidemiology
  • Young Adult