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Racial, health care disparities found in hospitalization for psoriasis

Patients with psoriasis had prolonged hospital stays compared with patients without the disorder, and there were significant racial and ethnic, socioeconomic and heath care disparities related to hospitalization for psoriasis, according to recently published study results.

Jonathan I. Silverberg, MD, PhD, MPH, of the department of dermatology, Northwestern University Feinberg School of Medicine, and colleagues analyzed the 2002 to 2012 Nationwide Inpatient Sample which contains approximately a 20% representative sample of all hospitalizations in the United States. ICD-9-CM codes were used to determine a primary diagnosis of psoriasis and psoriatic arthritis.

Jonathan I. Silverberg

Nonwhite race, including Asian (OR = 2.08; 95% CI, 1.55-2.78), black (OR = 1.65; 95% CI, 1.43-1.89) and multiracial/other (OR = 1.54; 95% CI, 1.13-2.11) and insurance status, including Medicare (OR = 1.33; 95% CI, 1.26-1.4), Medicaid (OR = 1.32; 95% CI, 1.25-1.4) and uninsured (OR = 1.94; 95% CI, 1.64-2.3) were associated with hospitalization.

Patients with a psoriasis and patients with psoriasis and psoriatic arthritis did not have significant in cost of care (mean $7,433.1 ± $254.4 vs. $7,234.8 ± $573.6), but the costs were significantly less than for patients without psoriasis ($9,956 ± $76; P = .002).

There was a significantly longer length of stay for patients with primary diagnosis of psoriasis (5.4 ± 0.2 days) compared with patients with no psoriasis (4.6 ± 0.02 days; P < .0001).

Patients with primary diagnosis of psoriasis had a mean adjusted in-hospital mortality of 0.4%, whereas patients with no diagnosis of psoriasis had a mean adjusted in-hospital mortality of 1.8%.

“The study demonstrated significant racial, socioeconomic and health care disparities, with higher rates of hospitalization in patients who were nonwhite, in lower income areas, underinsured and uninsured,” the researchers wrote. “In contrast, previous studies suggested that whites have the highest rates of psoriasis overall.”

“This study indicates there is a substantial inpatient burden of psoriasis, with consistently prolonged [length of stay] in patients with psoriasis compared to those without psoriasis,” the researchers concluded. “Future research is needed to better understand and develop clinical and policy interventions to best address these disparities.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.