Impact of a Pediatric Dermatology Service on Emergency Department Utilization for Children with Dermatitis

Beal, Brandon T.; Prodanovic, Edward; Kuo, Jimmy E.; Armbrecht, Eric S.; Peter, John R.; Siegfried, Elaine C.

doi:10.1111/pde.12688

Cited by 10 publications

(9 citation statements)

References 13 publications

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“…These encounters, termed here touchpoints, include admissions, emergency department (ED),urgent care and primary care provider (PCP) visits, and telephone encounters. 8,9 Touchpoints represent costs that may be mitigated if a patient is able to be evaluated by a dermatologist sooner.…”

Section: Stephens Et Almentioning

confidence: 99%

“…While they wait, we suspected that patients may have multiple health care encounters related to a dermatologic complaint before formal evaluation by a dermatologist. These encounters, termed here touchpoints, include admissions, emergency department (ED),urgent care and primary care provider (PCP) visits, and telephone encounters . Touchpoints represent costs that may be mitigated if a patient is able to be evaluated by a dermatologist sooner.…”

Section: Introductionmentioning

confidence: 99%

“…5 While they wait, we suspected that patients may have multiple health care encounters related to a dermatologic complaint before formal evaluation by a dermatologist.These encounters, termed here touchpoints, include admissions, emergency department (ED),urgent care and primary care provider (PCP) visits, and telephone encounters. 8,9 Touchpoints represent costs that may be mitigated if a patient is able to be evaluated by a dermatologist sooner.Another consequence of these long wait times is that patients may ultimately not attend scheduled appointments. 10-12 Depending on practice size, the nonattendance rate at pediatric dermatology clinics ranges from 15 to 25 percent.…”

mentioning

confidence: 99%

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Wait times, health care touchpoints, and nonattendance in an academic pediatric dermatology clinic

Stephens

Murthy

McMahon

2019

Pediatric Dermatology

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Background and objectives Timely access to pediatric dermatology care remains a challenge. While awaiting appointments, many patients and families utilize so‐called health care touchpoints outside of the dermatology clinic such as primary care or emergency department visits to address dermatologic concerns. Long waiting periods also factor into nonattendance rates at pediatric dermatology appointments. This observational retrospective study investigated wait times, relevant health care touchpoints, and factors related to nonattendance at a pediatric dermatology clinic. Methods We reviewed demographic, health care touchpoint, and nonattendance data for patients referred by a primary care affiliate to the Children's Hospital of Philadelphia (CHOP) pediatric dermatology clinic from February 2016 to May 2017. Descriptive statistics were used to identify trends among analyzed variables. Results We reviewed 250 patient records. The average number of touchpoints per patient was 0.56, and factors that significantly correlated with increased numbers of touchpoints included younger patient age and longer wait time while payer, primary diagnosis, and time of year were not associated. The nonattendance rate was 26%, and factors significantly associated with increased nonattendance rate included longer wait times and winter and spring appointments. Conclusion Long wait times impact numbers of touchpoints and appointment attendance rate when referring to pediatric dermatology. A platform such as teledermatology may represent an opportunity to improve access to care by allowing for earlier input from the pediatric dermatologist.

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Section: Stephens Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Wait times, health care touchpoints, and nonattendance in an academic pediatric dermatology clinic

Stephens

Murthy

McMahon

2019

Pediatric Dermatology

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“…Of the studies found within this review, the most commonly evaluated intervention types were topical calcineurin inhibitors (n = 14), [15][16][17][18][19][20][21][22][23][24][25][26][27][28] followed by infant formula feeds intended to prevent eczema from developing (n = 10). [29][30][31][32][33][34][35][36][37][38] Six studies evaluated a change of service delivery, including the use of web-based consultations, 39 delivering care by a nurse practitioner, [40][41][42] the development of a paediatric dermatology service (although what this entailed was not described) 43 and the use of interdisciplinary group sessions with an educational counterpart. 44 Mason et al also evaluated an educational support programme, which included the provision of an educational DVD and telephone support.…”

Section: Resultsmentioning

confidence: 99%

“…41 While Boguniewicz et al did perform a cost analysis, the study focused more so on the development of a framework for assessing outcomes, intended to inform future research. 17 Four studies completed retrospective cost analyses using administrative databases, 21,22,43,60 and one feasibility study identified potential cost drivers for a future trial. 50 Only one study explored the potential methodological challenges in costing eczema interventions and care.…”

Section: Cost Studiesmentioning

confidence: 99%

Understanding economic evidence for the prevention and treatment of atopic eczema

2019

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Summary Background Atopic eczema is an inflammatory skin condition, with a similar impact on health‐related quality of life as other chronic diseases. Increasing pressures on resources within the National Health Service increase the importance of having good economic evidence to inform their allocation. Objectives To educate dermatologists about economic methods with reference to currently available economic evidence on eczema. Methods The role of different types of economic evidence is illustrated by evidence found in a systematic literature search conducted across 12 online databases up to 22 May 2017. Primary empirical studies either reporting the results of a cost‐of‐illness study or evaluating the cost, utility or full economic evaluation of interventions for preventing or treating eczema were included. Two reviewers independently assessed studies for eligibility and performed data abstraction, with disagreements resolved by a third reviewer. Evidence tables of results were produced for narrative discussion. The reporting quality of economic evaluations was assessed. Results Seventy‐eight studies (described in 80 papers) were deemed eligible. Thirty‐three (42%) were judged to be economic evaluations, 12 (15%) cost analyses, six (8%) utility analyses, 26 (33%) cost‐of‐illness studies and one a feasibility study (1%). The calcineurin inhibitors tacrolimus and pimecrolimus, as well as barrier creams, had the most economic evidence available. Partially hydrolysed infant formula was the most commonly evaluated prevention. Conclusions The current level of economic evidence for interventions aimed at preventing and treating eczema is limited compared with that available for clinical outcomes, suggesting that greater collaboration between clinicians and economists might be beneficial.

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Cost analysis of a store-and-forward teledermatology consult system in Philadelphia

Yang

Barbieri

Kovarik

2019

Journal of the American Academy of Dermatology

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Impact of a Pediatric Dermatology Service on Emergency Department Utilization for Children with Dermatitis

Cited by 10 publications

References 13 publications

Wait times, health care touchpoints, and nonattendance in an academic pediatric dermatology clinic

Wait times, health care touchpoints, and nonattendance in an academic pediatric dermatology clinic

Understanding economic evidence for the prevention and treatment of atopic eczema

Cost analysis of a store-and-forward teledermatology consult system in Philadelphia

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