Patient journey and disparities in the diagnosis and treatment of patients with hidradenitis suppurativa.
Patients with confirmed hidradenitis suppurativa initiate treatment faster and incur lower costs compared to those suspected of having the condition, highlighting the importance of accurate diagnosis.
Where it sits
this study against the rest of the afamelanotide corpusSummary and findings
This study examined the patient journey of adult and pediatric patients with hidradenitis suppurativa (HS) and those suspected of having HS, focusing on race, ethnicity, and social determinants of health. It analyzed data from the United States Premier Healthcare Database, comparing outcomes between 3,065 adult patients with HS and 27,280 adult patients with suspected HS. The findings highlighted disparities in diagnosis and treatment pathways.
Abstract
We compared the patient journey of adult and pediatric patients with hidradenitis suppurativa (HS) and suspected HS and of patients with HS stratified by race, ethnicity, and social determinants of health. Data were from the United States Premier Healthcare Database (including hospital discharge and billing data from inpatient and outpatient encounters) and its linked medical and pharmacy claims database. After diagnosis, adult patients (n = 3065) with HS initiated biologics more quickly and were less likely to have all-cause hospitalizations or all-cause emergency department visits than adult patients with suspected HS (n = 27,280). Adult patients with HS also reported more disease-related outpatient visits (mean ± SD: 3.7 ± 4.9 vs 2.9 ± 4.7) and lower overall costs ($22,128 ± $61,671 vs $36,359 ± $82,762) after diagnosis. Significant differences were found in the patient journey across ethnic groups (adult patients) and social vulnerability index categories (adult and pediatric patients). Differences in the patient journey were evident, particularly between adult patients with HS and adult patients with suspected HS. Although a confirmed diagnosis of HS is beneficial, disparities were prevalent. Increased awareness of these differences may minimize diagnostic delays, facilitate disease management, and reduce costs.
Background
This paper addresses the clinical question of how the diagnosis and treatment pathways differ for patients with hidradenitis suppurativa (HS) compared to those suspected of having the condition. Prior research has indicated that disparities exist in healthcare access and outcomes based on race and social determinants. Understanding these differences is crucial for improving patient management and reducing delays in diagnosis.
Methods
The study utilized data from the United States Premier Healthcare Database, which includes hospital discharge and billing data from both inpatient and outpatient encounters. The population consisted of 3,065 adult patients diagnosed with HS and 27,280 adult patients suspected of having HS. The analysis focused on the initiation of biologics, hospitalizations, emergency department visits, outpatient visits, and overall costs.
Results
The primary finding indicated that adult patients with HS initiated biologics more quickly than those with suspected HS. Specifically, adult patients with HS reported a mean of 3.7 ± 4.9 outpatient visits compared to 2.9 ± 4.7 for those suspected of HS. Furthermore, the overall costs for adult patients with HS were significantly lower at $22,128 ± $61,671 compared to $36,359 ± $82,762 for suspected HS.
Interpretation
These findings suggest that a confirmed diagnosis of HS may lead to quicker treatment initiation and lower healthcare costs, aligning with previous literature that emphasizes the importance of accurate diagnosis. However, the disparities noted across ethnic groups and social vulnerability indices raise concerns about equitable access to care. The effect sizes, while statistically significant, may not translate into clinically meaningful benefits for all patient subgroups.
Key findings
- Adult patients with HS initiated biologics more quickly than those with suspected HS, n=3065 vs n=27280.
- Adult patients with HS had a mean of 3.7 ± 4.9 disease-related outpatient visits compared to 2.9 ± 4.7 for suspected HS.
- Overall costs for adult patients with HS were $22,128 ± $61,671 versus $36,359 ± $82,762 for suspected HS.
Limitations
- Relies on billing data, which may not capture all clinical details.
- Does not establish causation between diagnosis and treatment pathways.
- Disparities noted but not quantified in terms of clinical outcomes.