From flare to care: Dermatologists' impact on pediatric atopic dermatitis hospital admissions

Background/Objectives: Atopic dermatitis (AD) is a common chronic skin disease in the pediatric population; however, rates of admissions for flares in patients established with dermatology compared to those that are not established have not been fully assessed in prior studies. Methods: We reviewed electronic medical records of patients hospitalized (billing codes 99221-99223, 99217) with diagnoses encompassing AD, eczema, and dermatitis (ICD-10 codes L20.8-L20.9, L30.8-L30.9) between January 1, 2011, and December 31, 2021, at University Hospitals (UH) in Cleveland, Ohio. Patients were considered established with dermatology if they had been seen by a dermatology provider within 6 months prior to admission. Statistical analysis was performed using chi-square goodness of fit. Results: A total of 95 patient encounters met criteria for inclusion. Fifteen (15.8%) patients were established with dermatology at the time of admission and 80 (84.2%) were not. The chi-square value (x2 = 44.74) was greater than the critical value of 10.828 at one degree of freedom (p < .001). There were 8 patients who had more than one admission for atopic dermatitis flares; 2 of these patients were established with dermatology prior to their first admission, and 4 were established at the time of the second admission. Conclusion: The majority of patients admitted with AD flare were not established with dermatology. Many of these patients lived in a low socioeconomic area and missed follow-up appointments. Increasing access to dermatologic care for patients with atopic dermatitis, especially in lower-income areas, could aid in decreasing atopic dermatitis-related hospitalizations.