High Rates of Skin Disease Readmission Represent Significant Cost Burden

Recent research presented at the AAD 2018 Annual Meeting found that rates of readmission for skin disease are increasing and represent a massive financial burden for the United States health care system.

Justin D Arnold, MMSc, of the School of Medicine and Health Sciences at George Washington University, and colleagues explained that because of programs in the ACA designed to reduce readmissions, high skin disease burden could be hurting hospitals.

“Hospital Readmissions Reduction Program (HRRP), created under the ACA, penalizes hospitals with all-cause readmissions in excess of the national average for index stays related to specified medical and surgical discharges,” they wrote.

The researchers studied a nationwide readmission database for ICD-9 dermatology-related 30-day readmissions in 2014.

Study results showed that dermatology readmissions represent $1.05 billion annually, with 647,251 hospitalizations in 2014. 

The researchers found that the overall 30-day readmission rate for patients with dermatological disease was 12.63%. Among these readmissions, patients with cutaneous lymphomas, connective tissue disorders, and cutaneous congenital abnormalities had the highest readmission rates, ranging from 23.86% to 39.62%. 

Other drivers of high readmission rates identified by the researchers included, public insurance, residence in low-income areas, increasing number of chronic conditions, and admission to a large hospital. They also noted that admission to a nonteaching hospital was associated with lower readmission rates. 

“Readmissions for skin disease represent a significant financial burden to the health care system,” Dr Arnold and colleagues concluded. “Reimbursements from the CMS are reduced by up to 3% if readmission rates… exceed the national average. Our results suggest that additional factors influence readmission rates.”

—David Costill