The Inpatient Burden of Pediatric Dermatology in the United States: A National Analysis of the 2022 Kids' Inpatient Database

BACKGROUND: Dermatologic conditions are a significant reason for pediatric hospitalizations in the United States. A prior analysis of the 2012 Kids' Inpatient Database (KID) established a national benchmark for this burden, but changes in medical coding, healthcare delivery, and demographics necessitate an updated assessment. This study aimed to quantify the current inpatient burden of pediatric dermatology and to identify associated demographic risk factors, financial costs, and mortality using a recent, nationally representative database. METHODS: A cross-sectional study was conducted using the 2022 KID. Pediatric hospitalizations with a primary dermatology diagnosis (ICD-10-CM) were identified. Survey weights were used to generate national estimates of admission counts, costs, and mortality. Multivariable logistic regression was used to identify independent risk factors for a primary dermatology hospitalization. RESULTS: In 2022, there were an estimated 29,766 pediatric dermatology hospitalizations, representing 2.3% of all pediatric admissions and a decline from 4.2% in 2012. These admissions generated a total national cost of $449.3 million. After adjusting for covariates, factors associated with higher odds of a dermatology admission included age 2-5 years (OR: 1.35; 95% CI: 1.21-1.52), Asian/Pacific Islander race (OR: 1.49; 95% CI: 1.32-1.69), Native American race (OR: 1.17; 95% CI: 1.00-1.36), Hispanic ethnicity (OR: 1.07; 95% CI: 1.01-1.14), lowest income quartile (OR: 1.06; 95% CI: 1.01-1.12), and Medicaid coverage (OR: 1.09; 95% CI: 1.04-1.14). Female sex was associated with lower odds (OR: 0.95; 95% CI: 0.92-0.98). In-hospital mortality was 0.1%. CONCLUSION: The national burden of inpatient pediatric dermatology has decreased over the past decade. However, significant disparities related to socioeconomic status and race/ethnicity persist and have evolved. These findings underscore the continued need for interventions aimed at improving access to outpatient dermatologic care for underserved pediatric populations.