Who uses the emergency department for dermatologic care? A statewide analysis

Abstract

Background: Emergency department (ED) visits for skin symptoms are on the rise. The nature of these visits is not yet well characterized.

Objective: We sought to conduct a longitudinal analysis comparing patients discharged from the ED with dermatologic primary diagnoses to those with nondermatologic primary diagnoses.

Methods: Using the California State ED Database, we compared demographic variables and visit characteristics of patients discharged with dermatologic primary diagnoses (International Classification of Diseases, Ninth Revision, Clinical Modification codes 680-709) to those of patients discharged with nondermatologic primary diagnoses from 2005 to 2011.

Results: Patients given dermatologic primary diagnoses in the ED were more likely to be male, aged 18 to 54 years, white or Native American, and low income. They tended to be self-pay patients or have Medicaid, to live in less populous areas, and to visit the ED on the weekend.

Limitations: Results from California may not be generalizable nationally. The databases we used were based on administrative records, which have limited clinical detail.

Conclusion: The population of patients discharged home from the ED with dermatologic primary diagnoses appears to differ significantly from the population receiving nondermatologic primary diagnoses.

Keywords: dermatology; emergency department; health care quality, access, and evaluation; health care reform; health services accessibility; utilization.