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Racial, socioeconomic disparities exist in pemphigus hospitalizations

Patients with pemphigus who were nonwhite, had lower income, or were uninsured or underinsured experienced higher rates of hospitalization, according to study results recently published in JAMA Dermatology.

Jonathan I. Silverberg, MD, PhD, MPH, and colleagues analyzed the 2002-2012 Nationwide Inpatient Sample (NIS) provided by the Healthcare Cost and Utilization Project from the Agency for Healthcare Research and Quality.

Jonathan I. Silverberg

The NIS reported 87,039,711 hospitalization discharges, including 1,185 patents admitted for primary diagnosis of pemphigus (mean age, 57.7 years) and 5,221 patients admitted for secondary diagnosis of pemphigus (mean age, 70.6 years). The mean age of patients without a diagnosis of pemphigus was 47.9 years. Analysis took place between June 1 and Aug. 30, 2015.

When weighted to factor in the entire hospitalized U.S. cohort, the weighted frequencies were 5,647 for primary diagnosis of pemphigus and 24,880 for secondary diagnosis of pemphigus.

Hospitalization for pemphigus was associated with increasing age; female sex; nonwhite race or ethnicity, including black, Hispanic, Asian or Native American; lower household income; being insured with Medicare or Medicaid; number of chronic conditions; hospital location in a metropolitan area; and summer season.

Primary inpatient diagnosis of pemphigus had an inflation-adjusted care cost of $74,466,305 and a mean annual cost of $14,520.93. There was an increase in inflation-adjusted cost of care for patients with a primary diagnosis of pemphigus (P < .01).

Racial or ethnic minorities compared with whites, lower-quartile household income and patients without private insurance, including Medicare, Medicaid and no charge, were reported to have greater lengths of stay in the hospital.

“Patients with a decreased access to dermatologic care and/or prescription medication coverage may have exacerbation of pemphigus and secondary infections,” Silverberg and colleagues wrote. “The findings of this study indicate that the inpatient burden of pemphigus is extensive. Future research is needed to better understand the reasons for such disparities and identify optimal strategies to reduce these disparities.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.