Economic burden of cutaneous infections in children and adults with atopic dermatitis.
BACKGROUND/OBJECTIVES
Atopic dermatitis (AD) is a chronic, inflammatory disease affecting both children and adults. AD is associated with multiple comorbidities and complications. In particular, AD patients are susceptible to developing cutaneous infections. Studies show that comorbidities have contributed significantly to increased health care utilization and costs in AD. However, evidence regarding the degree to which this increased health care utilization and expenditure in AD is attributable to cutaneous infections is lacking. The aim of this study was to assess the impact of skin infections on health care utilization and expenditures among patients with atopic dermatitis.


METHODS
This cross-sectional study examined health care utilization and expenditures for AD patients of all ages with and without skin infections in the United States using the nationally representative 1996-2015 Medical Expenditure Panel Survey (MEPS) data.


RESULTS
In this study, a total of 4 825 668 (weighted) patients had a diagnosis of AD (mean age 5.7). Of these, 776 753 patients (16%) experienced skin infections (mean age 4.4). Compared to AD patients without skin infections, those with skin infections had more frequent visits to ambulatory clinics (P = 0.001) and the emergency department (P = 0.011), and increased hospitalization (P = 0.010), after adjustments for demographic and clinical factors. AD patients with skin infections were also given 3.3 more prescriptions (P < 0.0001). AD patients with skin infections incurred significantly greater health care costs, which included an additional $351/patient/year for ambulatory visits (P < 0.0001) and an additional $177/patient/year for prescription medications (P < 0.0001).


CONCLUSIONS
Atopic dermatitis patients with cutaneous infections incurred significantly greater health care utilization and expenditures than those without cutaneous infections.
['Sandhu|Jeena K|JK|', 'Salame|Nicole|N|https://orcid.org/0000-0002-6640-8944', 'Ehsani-Chimeh|Nazanin|N|', 'Armstrong|April W|AW|https://orcid.org/0000-0002-6892-6286']
D000293:Adolescent D000328:Adult D000553:Ambulatory Care D002648:Child D002675:Child, Preschool D017281:Cost of Illness D003430:Cross-Sectional Studies D003876:Dermatitis, Atopic D004636:Emergency Service, Hospital D005260:Female D017048:Health Care Costs D005102:Health Expenditures D006760:Hospitalization D006801:Humans D008297:Male D055553:Prescription Drugs D012874:Skin Diseases, Infectious D014481:United States D055815:Young Adult
infections atopic dermatitis health care utilization cost expenditures skin infections eczema