Racial, Healthcare Disparities Associated with Hospitalization for Psoriasis

While psoriasis has long been linked to other inflammatory conditions, there is little information about psoriasis-related hospitalization.

Researchers conducted a cross-sectional study to determine the risk factors for hospitalization and its associated inpatient burden, including cost of care, length of stay, and in-hospital mortality.

Jonathan I. Silverberg, MD, PhD, MPH, Northwestern University Feinberg School of Medicine, and colleagues analyzed the Nationwide Inpatient Sample from 2002-2012, which included a nearly 20% representative sample of all the hospitalizations in the US.

They used ICD-9-CM codes to determine a primary diagnosis of psoriasis and psoriatic arthritis.

The team discovered there were significant racial and ethnic, socioeconomic, and healthcare disparities regarding hospitalizations for psoriasis — nonwhite race, including Asian, black and multiracial/other, and insurance status were associated with hospitalization.

Results indicated:

· Mean cost of care was lower for a primary diagnosis of psoriasis in comparison with patients without psoriasis

· Length of stay was significantly prolonged for patients with a primary diagnosis of psoriasis compared with no psoriasis

· Mean adjusted in-hospital mortality for primary diagnosis of psoriasis was 0.4%, whereas only 1.8% for patients without a diagnosis of psoriasis

Based on the findings, higher rates of hospitalization were seen in patients who were nonwhite, in lower income areas, underinsured, and uninsured. “This stresses the need for improved access to dermatologic care for all patients,” the authors concluded.