Outpatient utilization patterns for atopic dermatitis in the United States

Singh, Partik; Silverberg, Jonathan I.

doi:10.1016/j.jaad.2019.03.021

Cited by 20 publications

(11 citation statements)

References 18 publications

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“…Atopic dermatitis (AD) is associated with a considerable financial burden, consisting of elevated direct costs related to healthcare resource utilization and indirect societal costs secondary to lost work productivity [ 22 – 27 ]. From the perspective of individual households, out-of-pocket (OOP) expenses are an essential and tangible element in routine management of finances.…”

Section: Introductionmentioning

confidence: 99%

Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among black individuals in the United States

et al. 2021

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Black race is associated with increased atopic dermatitis (AD) severity and healthcare resource utilization. However, the burden of out-of-pocket (OOP) expenses among black individuals with AD is not well understood. We sought to characterize the categories and impact of OOP healthcare expenses associated with AD management among black individuals. A 25-question voluntary online survey was administered to National Eczema Association members (N = 113,502). Inclusion criteria (US residents age ≥ 18 years; self-report of AD or primary caregivers of individuals with AD) was met by 77.3% (1118/1447) of respondents. Black individuals with AD were younger, had lower household income, Medicaid, urban residence, poor AD control and frequent skin infections (P ≤ 0.02). Blacks vs. non-blacks reported more OOP costs for prescription medications covered (74.2% vs. 63.6%, P = 0.04) and not covered (65.1% vs. 46.5%, P = 0.0004) by insurance, emergency room visits (22.1% vs. 11.8%, P = 0.005), and outpatient laboratory testing (33.3% vs. 21.8%, P = 0.01). Black race was associated with increased household financial impact from OOP expenses (P = 0.0009), and predictors of financial impact included minimally controlled AD (adjusted OR [95% CI] 13.88 [1.63–117.96], P = 0.02), systemic therapy (4.34 [1.63–11.54], 0.003), > $200 monthly OOP expenses (14.28 [3.42–59.60], P = 0.0003), and Medicaid (4.02 [1.15–14.07], P = 0.03). Blacks with Medicaid had higher odds of harmful financial impact (3.32 [1.77–6.24], P = 0.0002) than those of black race (1.81 [1.04–3.15], P = 0.04) or with Medicaid (1.39 [1.02–1.88], P = 0.04) alone. Black race is associated with increased OOP costs for AD and significant household financial impact. Targeted interventions are needed to address financial disparities in AD.

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Section: Introductionmentioning

confidence: 99%

Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among black individuals in the United States

et al. 2021

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“…Children and adults with AD have more outpatient office visits, 9,14 emergency department visits, 9,15 and hospital admissions with prolonged hospitalizations 9,16,17 in the United States compared with those without AD. Increased health care resource utilization is associated with substantial direct costs and increasing costs over time even after adjusting for inflation 15,17 .…”

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confidence: 99%

Financial Burden of Atopic Dermatitis Out-of-Pocket Health Care Expenses in the United States

et al. 2020

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Background: Atopic dermatitis (AD) is associated with considerable financial cost. However, the full burden of out-ofpocket (OOP) expenses is not well understood.Objective: We sought to characterize the OOP health care expenses associated with AD management. Methods: A 25-question voluntary online survey was administered to National Eczema Association members worldwide (n = 113,502). Inclusion criteria (US residents age ≥18 years who either self-reported had AD or were primary caregivers of individuals with AD) were met by 77.3% (1118/1447) of respondents. Results: Respondents reported OOP expenses in 3 categories: (1) health care providers and prescriptions, including health care provider visit deductibles (68.7% [686]), prescription co-pays (64.3% [635]), and prescriptions not covered by insurance (48.6% [468]); (2) nonprescription health care products, including moisturizers (94.3% [934]), hygiene products (85.0% [824], allergy medications (75.1% [715]), itch relievers (68.25% [647]), dietary supplements (52.2% [491]), and sleep aids (37.0% [336]); and (3) complementary approaches, including cleaning products (74.7% [732]), clothing/bedding (44.8% [430]), alternative medications (19.0% [180]), and adjunctive therapies (15.

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“…First, US dermatologists and allergists saw a higher proportion of patients with chronic AD, whereas generalists saw more patients with acute AD flares. 43 Moreover, dermatologists and allergists were more likely to use high-and ultrahigh-potency corticosteroids. 44 Taken together, dermatologists and allergists seem to manage AD patients with more severe and persistent disease that is refractory to treatment, which may contribute to lower overall satisfaction.…”

Section: Discussionmentioning

confidence: 99%