Inpatient dermatology: Where are we headed? A nationwide population‐based study of Spain from 2006 to 2016

Abstract

Summary Background and objectives Information about hospital admissions for skin diseases is restricted to studies describing admissions to single centers, to specific wards, or only for a few diagnoses, and there is no information about the outcomes between different wards. The aim of this research is to describe hospital admissions due to dermatological diseases. Patients and methods Cross‐sectional study of hospital discharges at Spanish hospitals. Discharges were assumed to be the same as admissions. Results 519,440 discharges (1.1 % of total discharges) were identified. Most admissions (60.1 %) were done from emergency departments. Only 7 % of cases were admitted to dermatology wards. The most prevalent group was cellulitis and acute lymphangitis. Median age was 57 years, and men were more common. The median length of hospital stay was four days; 40,823 (7.9 %) cases required readmission. There were 13,558 (2.6 %) hospital deaths. After adjusted analysis (by age, sex and group of diagnosis), the OR of readmission was 1.49 (95 % CI: 1.42–1.57) times higher and length of stay was 0.22 (95 % CI: 0.15–0.29) days longer in non‐dermatology wards (P < 0.0001). From 2006–2016, admissions to dermatology wards decreased 38 %, while in non‐dermatology wards they increased 8 %. Conclusions A non‐negligible number of patients require dermatological inpatient management. This is mainly provided by non‐dermatologists. Some of our findings may indicate an improved overall care by dermatologists.

The characteristics of dermatology inpatients seen at the quaternary Inkosi Albert Luthuli Central Hospital in Durban, South Africa, over a 5-year period – 2015 - 2020

“…[12] Within our hospital, consultations from other departments predominate the inpatient workload for our dermatologists, as observed in other countries. [11] Unlike in other studies, [15,16] the discipline of surgery, mostly through the plastic and reconstructive department, had the greatest need for the dermatology consultation service. This may be explained by common diseases encountered or managed by dermatology and plastic surgery, such as cutaneous malignancies and keloids.…”

“…As expected, >90% of all dermatology inpatient services are offered in the consultation service, with only 3.8% being managed as dermatology inpatients. [11] The median (IQR) age of the study population was 42.0 (28.0 -58.0) years. Dermatology-admitted inpatients were younger than patients managed in the consultation service, with median ages of 37 years and 42 years, respectively.…”

Investigation of Consultations Requested by Dermatology Inpatient (Preprint)

“…admitted to dermatology wards were compared to those admitted to non-dermatology wards. 26 The former patients were found to have a lower risk of readmission and a shortened hospital stay.…”

Gender differences in unplanned hospital admission: A population‐based approach

“…Regarding skin diseases and musculoskeletal diseases, men were more likely to be hospitalized urgently for the global categories, while women were more prone to unplanned hospitalization for skin infections in particular. Likewise, another study that analyzed dermatological hospitalizations in Spain between 2006 and 2016 registered more male patients, and 61% of hospitalizations were unplanned (Cuenca‐Barrales et al, 2021). Along the same lines, Patelarou et al (2016) found in a Greek sample that musculoskeletal and skin symptoms were more commonly recorded as a cause of emergency care in men, although we do not have data on whether they were hospitalized in the same proportion.…”