Inpatient Consultative Dermatology

Biesbroeck, Lauren K.; Shinohara, Michi M.

doi:10.1016/j.mcna.2015.06.004

Cited by 20 publications

(25 citation statements)

References 51 publications

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“…Diagnostic procedures recommended by an appropriately consulted dermatologist yield a definitive diagnosis in up to 80% of cases. Moreover, 45% to 80% of diagnoses will change after dermatology consultation preventing unnecessary therapy and costly hospital stays [7]. Finally, dermatology consultation may also facilitate outpatient follow-up for a procedure rather than performing it during admission.…”

Section: Discussionmentioning

confidence: 99%

Utilization and Cost of Inpatient Dermatologic Procedures: A Cross-sectional Analysis

Schrom

Tripathi

Ezaldein

et al. 2019

Cureus

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Knowledge surrounding inpatient dermatologic procedure costs is limited; therefore to learn more, we performed a cross-sectional analysis of dermatologic procedures contained in a publicly available Washington State Comprehensive Hospital Abstract Reporting System database from 2014. Dermatologic procedure utilization and cost were evaluated based on several parameters including demographics, length of hospital stay, payments, and payers. SAS 9.4 was used for the analysis. A total of 14,768 patients underwent dermatologic procedures in 2014 and 81.0% were white. The average age was 53 years (SD = 0.17), and the average payment for all patients who underwent dermatologic procedures was $85,059.48 (SD = $1,284.34). The average hospital length of stay was 8.91 days (SD = 0.07). The most common admission type was elective (66.2%), the most common admit source was a non-healthcare facility point of origin (78.2%), the most common primary payer was Medicare (36.2%), and the most common procedure was incision and drainage of skin and subcutaneous tissue (26.5%), followed by closure of skin and subcutaneous tissue of other sites (20%). This analysis demonstrated that inpatient dermatologic procedures are a significant driver of inpatient health care costs, and it is critical to determine factors that increase inpatient costs related to dermatologic procedures in order to develop strategies for reducing healthcare costs.

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Section: Discussionmentioning

confidence: 99%

Utilization and Cost of Inpatient Dermatologic Procedures: A Cross-sectional Analysis

Schrom

Tripathi

Ezaldein

et al. 2019

Cureus

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“…Possible skin infections in HSCT patients include fungal, bacterial, viral, and parasitic infections [11][12][13][14]. These skin pathologies may have atypical presentations in immunocompromised patients, making a dermatology consultation an important consideration [15]. Dermatologists have been shown to more accurately diagnose skin pathologies compared to generalists, and diagnoses often change after consultation [16].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, dermatology consultation leads to improved diagnostic accuracy and avoids unnecessary treatments, which in turn can potentially lead to cost savings [16]. However, excluding large academic or teaching institutions, most hospitals only have dermatologists available as consultants rather than direct inpatient teams [15]. This study aimed to (1) identity the type and incidence of skin infections, (2) describe the use of diagnostic tests for infectious class identification, and (3) identify the role and prevalence of dermatology consults in diagnosis of skin infections.…”

Section: Introductionmentioning

confidence: 99%

Etiology, Diagnostic Testing, and Dermatology Consultation Utilization in Skin Infections in Hematopoietic Stem Cell Transplant Patients: A 5-year Review

Velez¹,

Toffel²,

Tremblay³

et al. 2019

Journal of Microbiology and Infectious Diseases

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Objectives: Hematopoietic stem cell transplantation (HSCT) patients are at higher risk of infection compared to their healthy counterparts. Aims were identity type and incidence of skin infections, describe the use of diagnostic tests, and identify the role of dermatology consults. Methods: In this single institution retrospective chart review, data were extracted from the medical record. A clinically diagnosed skin infection was defined as any skin pathology treated with antibiotics, antivirals, antifungals, or antiparasitics. The diagnostic tests data such as cultures, polymerase chain reactions (PCR), and direct fluorescent antibody (DFA) tests, and dermatology consultations were also collected. Results: A total of 92 patients and 143 skin infections were identified in the 5-year study period. The majority of infections occurred while the patient was not neutropenic. The infectious agents responsible for infections varied depending on a patient's age, neutropenia status, graft-versus-host disease (GVHD) diagnosis, and transplant type. Only 25 infections (17%) received a dermatology consultation. On average, infections associated with dermatology consultation received a higher number of diagnostic tests compared to those that did not receive a dermatology consultation. Conclusions: The etiologies and severities of clinically identified skin infections in HSCT patients are varied and require continuous vigilance of dermatological health. Dermatologists are not necessarily the physician's ordering more diagnostic. Therefore, earlier assessment by dermatologists might prevent excessive laboratory testing and earlier management of severe clinically identified infections.

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“…Las IC solicitadas abarcan una amplia gama de afecciones, que incluyen dermatosis inflamatorias, procesos infecciosos, reacciones adversas a medicamentos y trastornos neoplásicos, muchas de las cuales pueden diagnosticarse solo por el examen físico dermatológico, pero cuando es necesario, la biopsia cutánea puede aportar información importante relacionada con el diagnóstico [41].  Alta médica antes de la IC en seis casos.…”

Section: La Interconsulta Hospitalaria En Dermatologíaunclassified

“…Es importante realizar un diagnóstico diferencial con los exantemas virales y con las etapas iniciales de reacciones adversas cutáneas graves que incluyen el síndrome de DRESS, el SSJ y la NET.El tratamiento es de soporte, con la supresión del fármaco responsable, la aplicación de corticoides tópicos de potencia intermedia y el empleo de antihistamínicos orales para controlar el prurito. Se evita el uso de corticoides sistémicos, ya que no hay evidencia científica de que estos aceleren la resolución del cuadro[41].En el estudio realizado por Ding et al[99] en Malasia entre enero de 2001 y diciembre de 2008 destacaron en primer lugar las erupciones maculopapulares(39,5 %) Los mismos resultados aparecen en el estudio llevado a cabo por Botelho et al[101], en el que los anticonvulsivantes fueron responsables del 23,9 % de los casos, seguidos de los antibióticos (22,2 %). Las formas clínicas más frecuentes se correspondieron con exantema (37,6 %), DRESS (14,5 %), y SSJ/NET (12,8 %).Un estudio retrospectivo realizado en Singapur[102] recogió los datos referentes a las reacciones adversas cutáneas graves (SSJ, NET y DRESS) de enero de 2007 a diciembre de 2011.…”

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Estudio epidemiológico de las interconsultas hospitalarias solicitadas al Servicio de Dermatología en el Complejo Asistencial Universitario de León = Epidemiological study of the hospital inter-specialty referrals requested to the Dermatology Service of the Healthcare University Complex in León

García¹,

Camino²

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Conclusiones La afección dermatológica en pacientes hospitalizados es muy prevalente y se debe, principalmente, a enfermedades comunes, no graves y de fácil manejo. La actividad consultora conlleva un importante impacto en el manejo de los pacientes ingresados con afectación cutánea al originar un cambio en el diagnóstico y tratamiento en un elevado porcentaje de casos, implica una mejora en la calidad asistencial, supone una reducción del coste sanitario, comporta una importante actividad formativa para los médicos residentes y proporciona una relación directa con otras especialidades conformando un elevado valor educativo para los facultativos no dermatólogos.

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Inpatient Consultative Dermatology

Cited by 20 publications

References 51 publications

Utilization and Cost of Inpatient Dermatologic Procedures: A Cross-sectional Analysis

Utilization and Cost of Inpatient Dermatologic Procedures: A Cross-sectional Analysis

Etiology, Diagnostic Testing, and Dermatology Consultation Utilization in Skin Infections in Hematopoietic Stem Cell Transplant Patients: A 5-year Review

Estudio epidemiológico de las interconsultas hospitalarias solicitadas al Servicio de Dermatología en el Complejo Asistencial Universitario de León = Epidemiological study of the hospital inter-specialty referrals requested to the Dermatology Service of the Healthcare University Complex in León

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