U.S. adults with eczema reported significantly more out-of-pocket health care costs, lost workdays, and comorbid conditions than did their peers without eczema, according to a population-based study reported online March 4 in JAMA Dermatology.
Adult eczema patients also used significantly more health care resources than did adults without eczema, despite reporting more problems accessing care, said Dr. Jonathan I. Silverberg at Northwestern University in Chicago.
About 10.2% of U.S. adults have eczema (atopic dermatitis), but not much is known about its recent direct and indirect health care costs. To explore these questions, Dr. Silverberg analyzed data from the 2010 and 2012 National Health Interview Surveys, which included 27,157 and 34,613 adults, respectively (JAMA Dermatol. 2015 [doi:10.1001/jamadermatol.2014.5432]).
Eczema was linked to 53% higher odds of losing six or more workdays for any reason (odds ratio, 1.53; 95% confidence interval, 1.26-1.84), and with significantly higher odds of visits to physicians’ offices, emergency departments, urgent care centers, and hospitals for all causes, Dr. Silverberg reported. Adults with eczema also paid an estimated $371 to $489 more in out-of-pocket health care costs per year, compared with other adults, he added. “This study demonstrates that adults with eczema have a major health burden with significantly increased health care utilization and costs,” he emphasized.But greater utilization of care “was only partially due to eczema per se,” Dr. Silverberg noted. “There is likely a multitude of comorbid disorders associated with eczema that contributes toward the increased utilization, aside from EAH [eczema with allergy and/or hay fever], or food allergy,” he said. “Indeed, there were significant statistical interactions, such that adults with EAH had even greater burden of disease, out-of-pocket costs, and health care utilization.”
Past studies have shown that children with eczema have more extracutaneous infections, dental disease, and mental health problems, compared with peers who do not have eczema, Dr. Silverberg pointed out, adding that future studies should explore the clinical and financial implications of comorbidities in eczema patients.Eczema also was associated with impaired access to care, Dr. Silverberg said. Affected adults were significantly more likely to describe problems paying for prescriptions (OR, 2.36; 95% CI, 1.92-2.81), getting timely appointments (OR, 2.04; 95% CI, 1.73-2.41), and obtaining care because of worry about costs (OR, 1.66; 95% CI, 1.40-1.97), compared with adults without eczema, Dr. Silverberg said. “Future studies are needed to identify the determinants of health care utilization and access in adults with eczema,” he concluded.
The Agency for Healthcare Research and Quality funded the study. Dr. Silverberg reported having no relevant conflicts of interest.