PSY15 Utilizing Administrative DATA to Determine the Healthcare Burden for Atopic Dermatitis Patients

Abstract

Previous studies that have assessed atopic dermatitis (AD) burden have been conducted on surveys targeted to the general population. A major limitation is that the survey item that queries ‘recurrent red itchy rash’ lacks diagnostic validation for ascertaining AD cases. Furthermore, the burden on the healthcare system of these patients has not yet been adequately assessed. We use previous validated algorithms and universal administrative health data to determine the healthcare burden of AD. Population Data BC was utilized to ascertain AD cases, which encompasses provincial healthcare data for over 4.5 million residents in British Columbia. The following were calculated: i) incident and prevalence cases, ii) topicals and systemic agents used, iii) number of medical visits per year. In addition, the age distribution for accessing physician care and systemic treatments administered were analyzed. From 2004-2014, incident and prevalent AD cases ranged from 1.28-1.35% and 16.35-18.67%, respectively. The majority of cases were mild (90.41%). The highest frequency for cases accessing the healthcare system was for those aged 0-4 years (4.36%), incident cases per 5 year intervals ranged between 1-2%. The treatments given were as follows: low potency topical steroids-35.93%, moderate to high potency topical steroids-46.84%, high potency topical steroids-16.45%, ultra-high potency steroids-5.34%, topical immunomodulators-4.20%, systemic prednisone-8.41%, systemic immunosuppressants (except prednisone)-1.29%. Out of an average 49,861 AD patients presenting yearly, there were 65,794 general practitioner visits and 12,769 dermatology clinical visits, while other specialties were involved in less than 10% of visits. Although the prevalence of AD cases ranges from 15-20%, the proportion of cases accessing the healthcare system on a yearly basis is only 1-2% of the general population. General practitioners and dermatologists manage majority of cases within the BC healthcare system, and only a minority of patients require systemic immunosuppressant agents.