title: The inpatient burden of psoriasis in the United States.
abstract: BACKGROUND
  Although psoriasis has been linked to increased inpatient cardiovascular mortality, little is known about hospitalization for psoriasis and its inpatient burden in the United States in terms of frequency and cost.
  
  
  OBJECTIVE
  We sought to determine risk factors for hospitalization for psoriasis and quantify cost of care, length of stay, and in-hospital mortality.
  
  
  METHODS
  We conducted a cross-sectional study of the Nationwide Inpatient Sample from 2002 to 2012, containing a representative 20% sample of all US hospitalizations.
  
  
  RESULTS
  Hospitalization for psoriasis was associated with nonwhite race (Asian odds ratio [OR] 2.08, 95% confidence interval [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 (Medicare OR 1.33, 95% CI 1.26-1.40; Medicaid OR 1.32, 95% CI 1.25-1.40; and uninsured OR 1.94, 95% CI 1.64-2.30). Mean cost of care was lower for a primary diagnosis of psoriasis in comparison with patients without psoriasis ($7433 ± $254 vs $9956 ± $76; P = .002). Length of stay was significantly prolonged for patients with a primary diagnosis of psoriasis compared with no psoriasis (5.4 ± 0.2 vs 4.6 ± 0.02 days; P < .0001). Mean adjusted in-hospital mortality was 0.4% and 1.8% for a primary or no diagnosis of psoriasis, respectively.
  
  
  CONCLUSIONS
  We were unable to look at medication usage and its impact on hospitalization. Information regarding the severity of psoriasis and how this may have affected in-hospital procedures was not available.
  
  
  CONCLUSIONS
  There are racial and health care disparities in hospitalization for psoriasis, stressing the need for improved access to dermatologic care for all patients.
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Derek Y
authors.initials: DY
authors.lastname: Hsu
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Gordon
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: JonathanISilverberg@gmail.com.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Silverberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D054625:Healthcare Disparities / Q000191:economics*; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011565:Psoriasis / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States; D055815:Young Adult
keywords: burden; cost of care; hospitalization; inpatient; length of stay; mortality; psoriasis; racial disparities