Partik Singh1, Jonathan I Silverberg2. 1. Department of Dermatology, Feinberg School of Medicine, Northwestern University. 2. Department of Dermatology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University. Electronic address: JonathanISilverberg@gmail.com.
Abstract
BACKGROUND: The prevalence and demographics of atopic dermatitis (AD) have changed in the US. Little is known about trends and determinants of outpatient healthcare utilization. OBJECTIVE: Determine the trends and determinants of outpatient healthcare utilization for AD in US adults and children. METHODS: Data from the 1993-2015 National Ambulatory Medical Care Survey were analyzed, including 110,095 pediatric and 642,140 adult outpatient visits. RESULTS: AD visits occurred predominantly in primary care providers (PCPs) (768,882 mean visits annually), followed by dermatologists (466,529), and allergists (18,445). The frequency of AD visits increased from 1996-1999 to 2012-2015 overall (867,649 to 1,950,546 annually; Rao-Scott Chi square, P=0.02), particularly among PCPs (339,889 to 1,025,739; P=0.02). The frequency of AD visits to dermatologists decreased (446,669 to 371,003; P=0.01). AD visits to were most common among children age 0-4 years (32.0%). Adults with comorbid allergic rhinitis or food allergies had greater odds of seeing an allergist. AD visits were more likely to be acute visits among PCPs (51.5%), and chronic visits among dermatologists (41.2%). LIMITATIONS: AD severity was unavailable. CONCLUSIONS: Outpatient visits for AD increased in the US over time overall, but decreased for dermatologists. Dermatologists are most commonly seeing chronic AD visits and should tailor treatment appropriately.
BACKGROUND: The prevalence and demographics of atopic dermatitis (AD) have changed in the US. Little is known about trends and determinants of outpatient healthcare utilization. OBJECTIVE: Determine the trends and determinants of outpatient healthcare utilization for AD in US adults and children. METHODS: Data from the 1993-2015 National Ambulatory Medical Care Survey were analyzed, including 110,095 pediatric and 642,140 adult outpatient visits. RESULTS:AD visits occurred predominantly in primary care providers (PCPs) (768,882 mean visits annually), followed by dermatologists (466,529), and allergists (18,445). The frequency of AD visits increased from 1996-1999 to 2012-2015 overall (867,649 to 1,950,546 annually; Rao-Scott Chi square, P=0.02), particularly among PCPs (339,889 to 1,025,739; P=0.02). The frequency of AD visits to dermatologists decreased (446,669 to 371,003; P=0.01). AD visits to were most common among children age 0-4 years (32.0%). Adults with comorbid allergic rhinitis or food allergies had greater odds of seeing an allergist. AD visits were more likely to be acute visits among PCPs (51.5%), and chronic visits among dermatologists (41.2%). LIMITATIONS: AD severity was unavailable. CONCLUSIONS:Outpatient visits for AD increased in the US over time overall, but decreased for dermatologists. Dermatologists are most commonly seeing chronic AD visits and should tailor treatment appropriately.