855 Inpatient burden of prurigo nodularis in the United States

Abstract

Prurigo nodularis (PN) is an extremely pruritic, inflammatory skin disease that significantly affects quality of life. However, there is very limited epidemiologic data available worldwide on PN. With the advent of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) in 2015, PN received an individualized, dedicated diagnosis code for the first time, allowing for novel epidemiologic studies to better understand the disorder in the United States. The goal of the present study was to characterize risk factors associated with the hospitalization of PN patients and quantify the cost of care and length of hospital stay for these patients. We thus conducted a cross-sectional analysis of the National Inpatient Sample (NIS), a sample of 20% of hospital discharges, from 2016 (the first year to exclusively use ICD-10). We identified hospital discharges with a diagnosis of PN based on ICD-10 code. Risk factors for hospitalization of PN patients were determined by weighted multivariate logistic regression. An estimated 1325 patients diagnosed with PN were discharged in 2016. Hospitalization for PN was associated with older age, especially individuals age 40-69 years(p<0.001), those of nonwhite race (black adjusted odd ratio (aOR) 4.4, 95%CI [3.23-6.08]; Asian aOR2.66[1.39-5.08]), and insurance status (Medicare aOR2.82[1.81-4.38], p<0.001; Medicaid aOR2.24[1.44-3.46]). The mean length of stay was lower in patients with PN compared to patients without PN (6.5±0.4 days vs 4.62±0.02 days;p<0.001). The estimated financial burden for hospitalized patients with PN was $63±6 million in 2016. The mean cost of care for PN patients was $49,948±3,335, which was greater than the mean cost for the general inpatient population at $47,019±547, although the difference was not statistically significant. We conclude that significant racial and healthcare disparities exist in the hospitalization of PN patients, highlighting the necessity of increased access to care and greater awareness of this condition so effective therapies may be developed.