title: The Financial and Emotional Impact of Atopic Dermatitis on Children and Their Families.
abstract: OBJECTIVE
  To examine the personal financial impact of atopic dermatitis (AD) and attempt to correlate cost of AD with emotional impact.
  
  
  METHODS
  Between March 2011 and December 2013, 82 caretakers of children 6 months to 12 years of age with moderate-to-severe AD were recruited at the time of dermatology clinic visits in Cleveland, Ohio, to complete surveys. The response rate was >95%. Participants were asked questions about direct expenses (medical visits, medications, and other products) and indirect expenses (time missed from work, childcare costs) related to AD in the past 4 weeks. Emotional impact was measured by the Childhood Atopic Dermatitis Impact Scale.
  
  
  RESULTS
  The mean monthly personal cost of AD in the month before the office visit was $274 (median $114; IQR $29, $276), with $75 from direct costs (median $45; IQR $20, $110) and $199 from indirect costs (median $0; IQR $0, $208). An average of 34.8% of available monthly money was spent on AD care in the month before the office visit. For patients with Medicaid, there was a significant correlation between monthly adjusted personal cost and Childhood Atopic Dermatitis Impact Scale score (r = 0.548; P < .001); however, this correlation did not exist for patients who had commercial insurance (r = 0.269; P = .166).
  
  
  CONCLUSIONS
  Our results illustrate the high emotional and financial burden of childhood AD and provide insight into spending patterns. In addition, our study correlate costs with emotional burden of AD for lower-income patients.
authors.affiliation: Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH. Electronic address: mgf11@case.edu.
authors.forename: Michelle G
authors.initials: MG
authors.lastname: Filanovsky
authors.affiliation: Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH.
authors.forename: Suwimon
authors.initials: S
authors.lastname: Pootongkam
authors.affiliation: Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH.
authors.forename: Joan E
authors.initials: JE
authors.lastname: Tamburro
authors.affiliation: Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Smith
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ganocy
authors.affiliation: Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Nedorost
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003876:Dermatitis, Atopic / Q000191:economics* / Q000523:psychology*; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D009820:Ohio; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires