Outpatient utilization patterns for atopic dermatitis in the United States

Background: The prevalence and demographics of atopic dermatitis (AD) in the United States have changed. Little is known about trends and determinants of outpatient health care utilization. Objective: Determine the trends and determinants of outpatient health care utilization for AD in US adults and children. Methods: Data from the 1993-2015 National Ambulatory Medical Care Survey were analyzed, including data on 110,095 pediatric and 642,140 adult outpatient visits. Results: AD visits were made predominantly to primary care physicians (PCPs) (768,882 mean visits annually), dermatologists (466,529 mean visits annually), and allergists (18,445 mean visits annually). The frequency of AD visits increased overall from 1996-1999 to 2012-2015 (from 867,649 to 1,950,546 annually [Rao-Scott chi-square P = .02]), particularly among PCPs (from 339,889 to 1,025,739 [P = .02]). The frequency of AD visits to dermatologists decreased (from 446,669 to 371,003 [P = .01]). AD visits to PCPs were most common among children aged 0 to 4 years (32.0%). Adults with comorbid allergic rhinitis or food allergies had greater odds of seeing an allergist. AD visits to PCPs were more likely to be visits due to an acute condition (51.5%), whereas AD visits to dermatologists were more likely to be visits due to a chronic condition (41.2%). Limitations: AD severity was unavailable. Conclusions: Outpatient visits for AD in the United States over time increased overall, but those to dermatologists decreased. Dermatologists are most commonly seeing patients whose visit is due to chronic AD, and they should tailor treatment appropriately. ( J Am Acad Dermatol 2023;88:357-63.)

Automated summary

This study analyzed outpatient healthcare utilization trends and determinants for atopic dermatitis (AD) in US adults and children. The results showed an overall increase in AD visits over time, particularly among primary care physicians (PCPs). Children aged 0-4 years were the most common age group seeking outpatient care for AD.