Hospital readmissions among patients with skin disease: A retrospective cohort study.

Abstract

Hospital readmissions represent a potential target for reducing unnecessary health care expenditures; however, readmissions following dermatology hospitalizations remain poorly characterized. To assess the frequency and demographics of readmissions for skin disease. We performed a retrospective cohort study of dermatology hospitalizations by using the 2014 Nationwide Readmissions Database. Readmissions following dermatologic hospitalizations cost the American health care system $1.05 billion in 2014. The 30-day rate of all-cause readmission following the 647,251 weighted index admissions for skin disease was 12.63%. Readmission was most common following hospitalizations for cutaneous lymphomas (39.63%), connective tissue disorders (26.28%), and cutaneous congenital abnormalities (23.86%). Predictors of readmission included public insurance with Medicaid (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.53-1.70) or Medicare (OR, 1.55; 95% CI, 1.48-1.62), residence in a low-income community (OR, 1.14; 95% CI, 1.09-1.20), an increased number of chronic conditions (OR, 4.46; 95% CI, 4.15-4.79), and a large hospital (OR, 1.10; 95% CI, 1.05-1.16). Urban (OR, 0.90; 95% CI, 0.87-0.94) and rural (OR, 0.78; 95% CI, 0.73-0.82) nonteaching hospitals were protective against readmissions from skin disease. We were unable to assess the impact of inpatient dermatology consultations on hospital readmission rates. There are significant health care and demographic disparities in readmissions for skin disease.