Age-based health and economic burden of skin and soft tissue infections in the United States, 2000 and 2012

Abstract

ObjectiveThe aim of this study was to compare the incidence of skin and soft tissue infections (SSTIs) across healthcare settings and analyze direct healthcare expenditures related to SSTIs in 2000 and 2012 in the United States.MethodsWe performed a retrospective, cross-sectional analysis of nationally representative data from the Medical Expenditure Panel Surveys. Population-based incidence rates were examined for all healthcare settings that include inpatient visits, emergency department visits and ambulatory visits for SSTIs. The direct costs of healthcare services utilization were reported. Population-based prescribing rates for each antimicrobial class during ambulatory visits were compared.ResultsA total of 2.4 million patients experienced an SSTI in 2000 compared to 3.3 million in 2012 (40% increase). From 2000 to 2012, the incidence of patients with at least one hospital visit for SSTIs increased 22%, ambulatory care visits increased 30%, and emergency department visits increased 40%. The incidence of SSTIs in children and adolescents declined 50% (from 150 to 76 per 10,000 person; RR = 0.51, 95% CI: 0.38–0.67; p<0.001) whereas SSTIs in older adults (> 65 years of age) increased almost 2-fold (from 67 to 130 per 10,000 person; RR = 1.94, 95% CI: 1.44–2.61; p<0.001). The annual incidence of SSTI in adults did not change significantly from 2000 to 2012 (from 84 to 81 per 10,000 person; RR = 0.96, 95% CI: 0.71–1.31; p = 0.41). The total estimated direct healthcare costs of SSTIs increased 3-fold from $4.8 billion in 2000 to $15.0 billion in 2012, largely driven by an 8-fold increase in ambulatory expenditures for SSTIs. Total population-based antimicrobial prescription rates for SSTIs increased 4-fold from 2000 to 2012 (from 59.5 to 250.4 per 10,000 person).ConclusionsThe highest healthcare utilization for SSTI treatment occurred in the ambulatory care setting and also accounted for the largest increase in overall direct expenditures from 2000 to 2012.

Non-purulent skin and soft tissue infections: predictive power of a severity score and the appropriateness of treatment in a prospective cohort

“…Skin and soft tissue infections (SSTIs) are heterogeneous and among the most common causes of hospitalisation for antibiotic treatment [1,2]. The global burden of SSTIs is increasing, including non-purulent SSTIs such as cellulitis [3][4][5]. A major problem in the management of nonpurulent SSTIs is frequent over-treatment with use of broad-spectrum antibiotics, even in mild cases, partly reflecting difficulties in establishing the microbial aetiology [5].…”

Loop Drainage Is Noninferior to Traditional Incision and Drainage of Cutaneous Abscesses in the Emergency Department

“…Skin and soft tissue infections account for 29.7/1000 ED visits, which translates to approximately 3.4 million ED visits nationwide and $400 million in direct costs. [1][2][3] Importance Currently, over 90% of cutaneous abscesses are treated with traditional incision and drainage (I&D). 4 The technique involves making a large skin incision over the abscess, draining the pus, and placing a wick in the cavity to stent it open and prevent fluid reaccumulation.…”

“…Infections of the skin, including cellulitis and abscesses, are common reasons for patients to present to the emergency department (ED) in the United States. Skin and soft tissue infections account for 29.7/1000 ED visits, which translates to approximately 3.4 million ED visits nationwide and $400 million in direct costs 1–3 …”

Health-Related Quality of Life Impairment among Patients with Different Skin Diseases in Vietnam: A Cross-Sectional Study

“…Skin diseases, in many cases, are the potentially surface presentation of more serious illnesses such as HIV/AIDS or many neglected tropical diseases [2,6]. Regarding financial burden, patients with skin diseases are also more likely to suffer high medical cost and lost work productivity [7]. Moreover, severe skin-related symptoms on the face and body can deteriorate self-esteem and self-confidence of patients, which significantly affect their involvement in social activities [8,9,10].…”