Work

276 U.S. regional differences in psoriasis care: Healthcare utilization, costs, and access to biologics

Year: 2019

Type: article

Abstract: Regional differences in the U.S. in healthcare utilization and costs among psoriasis patients are unknown. However, patient location may critically impact their access to care. The objective of this study is to compare healthcare utilization, costs, and biologic medication use among patients with psoriasis in the four U.S. census regions: Northeast, Midwest, South, and West. We performed a cross-sectional study using the Medical Expenditure Panel Survey from the years 1996 to 2015. Among the 17,014,231 (weighted) psoriasis patients in the U.S. pooled during the 20-year period, 3,351,104 (19.7%) resided in the Northeast, 4,110,472 (24.2%) resided in the Midwest, 6,010,346 (35.3%) resided in the South, and 3,542,309 (20.8%) resided in the West. The average number of ambulatory visits and ambulatory costs per person per year were 3.8 visits and $1,320 in the Northeast, 2.9 visits and $387 in the Midwest, 3.0 visits and $725 in the South, 5.0 visits and $943 in the West, and 3.5 visits and $803 in the U.S. overall. Compared to the remainder of the county, more psoriasis patients in the South reported using biologic medications (9.87% vs 6.78%, p=0.045) and had 60% fewer emergency room (ER) visits (p=0.039), after adjustment for age, gender, race, ethnicity, and insurance status. Compared to the rest of the country, Midwest psoriasis patients had 23% fewer ambulatory visits and incurred less ambulatory costs ($387 vs $934/person/year, p<0.001). Exploratory analysis showed that those with no ambulatory visits in the Midwest had significantly more ER visits than those with one or more ambulatory visits (0.0293 vs 0.0007 visits/person/year, p<0.001). In conclusion, regional differences exist in healthcare utilization, costs, and biologic use. Patients in the South used more biologics and had fewer ER visits than the rest of the country. Midwest psoriasis patients had fewer ambulatory visits and costs compared to the rest of the country.

Source: Journal of Investigative Dermatology

DOI: 10.1016/j.jid.2019.03.352

Authors: K. Nguyen, K.K. Wu, C. Read, A.W. Armstrong

Institutions: University of Central Florida, Quinnipiac University

Language: English

Topic: Psoriasis: Treatment and Pathogenesis

Subfield: Immunology

Field: Immunology and Microbiology

Domain: Life Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

Estimated APC paid: $3,400