Direct and indirect costs of adult atopic dermatitis in an inpatient and outpatient setting

The chronicity of atopic dermatitis often carries a profound economic burden that affects the individual, their families and more broadly, the health care budget.
Our study examined the inpatient and outpatient costs associated with treatment of atopic dermatitis in the adult population at The Royal Melbourne Hospital. 27 patients were assessed on the basis of severity using the SCORing atopic dermatitis (SCORAD) scale. Indirect costs were measured using the Dermatology Life Quality Index (DLQI) and a supplemental questionnaire examining loss of income from the date of recruitment. Completion of an “atopic dermatitis cost diary” to record expenditures related to atopic dermatitis management over a 4-month period was also undertaken.
In the outpatient setting, results showed that the annual out-of-pocket cost for the individual and the health care system in patients with moderate to severe atopic dermatitis were $1019 and $887 respectively. Loss of income also increased with the degree of severity.
Retrospective analysis of inpatient admissions where atopic dermatitis was the principle diagnosis revealed a total of 11 admissions over a 1-year period. The total cost of these admissions was $77,068 with an average cost per day of $1014.
Whilst the emotional, physical and social impact of atopic dermatitis is undeniable, our study highlights the economic burden of this chronic disease. The exorbitant cost of inpatient care in particular reinforces that frequent and comprehensive continuity of outpatient care not only reduces the physical and psychological aspects of inpatient admission, but also the economic load on the health care budget.

Dr. Helena Lolatgis