{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:03:23Z","timestamp":1792555403858,"version":"4.5.0"},"reference-count":50,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec id=\"ab-doi220056-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Emergency department (ED) visitation is common for the treatment of hidradenitis suppurativa (HS), whereas dermatology outpatient care is low. The reasons underlying this differential follow-up have not been elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi220056-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the interventions and patient factors associated with ED return following an initial ED visit for HS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi220056-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This retrospective cohort study used data from the IBM\u00ae MarketScan\u00ae Commercial and Multi-State Medicaid databases (trademark symbols retained per database owner requirement). An HS cohort was formed from patients who had 2 or more claims for HS during the study period of 2010 to 2019 and with at least 1 ED visit for their HS or a defined proxy. Data were analyzed from November 2021 to May 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi220056-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Factors analyzed included those associated with the ED visit and patient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi220056-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Primary outcomes were return to the ED or dermatology outpatient follow-up for HS or related proxy within 30 or 180 days of index ED visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi220056-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 20\u202f269 patients with HS (median [IQR] age, 32 [25-41] years; 16\u202f804 [82.9%] female patients), of which 7455 (36.8%) had commercial insurance and 12\u202f814 (63.2%) had Medicaid. A total of 9737 (48.0%) patients had incision and drainage performed at the index ED visit, 14\u202f725 (72.6%) received an oral antibiotic prescription, and 9913 (48.9%) received an opioid medication prescription. A total of 3484 (17.2%) patients had at least 1 return ED visit for HS or proxy within 30 days, in contrast with 483 (2.4%) who had a dermatology visit (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). Likewise, 6893 (34.0%) patients had a return ED visit for HS or proxy within 180 days, as opposed to 1374 (6.8%) with a dermatology visit (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). Patients with Medicaid and patients who had an opioid prescribed were more likely to return to the ED for treatment of their disease (odds ratio [OR], 1.48; 95% CI, 1.38-1.58; and OR, 1.48; 95% CI, 1.39-1.58, respectively, within 180 days) and, conversely, less likely to have dermatology follow-up (OR, 0.16; 95% CI, 0.14-0.18; and OR, 0.81; 95% CI, 0.71-0.91, respectively, within 180 days).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi220056-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cohort study suggests that many patients with HS frequent the ED for their disease but are not subsequently seen in the dermatology clinic for ongoing care. The findings in this study raise the opportunity for cross-specialty interventions that could be implemented to better connect patients with HS to longitudinal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamadermatol.2022.4610","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T11:32:54Z","timestamp":1666783974000},"page":"1378","source":"Crossref","is-referenced-by-count":17,"title":["Factors Associated With Dermatologic Follow-up vs Emergency Department Return in Patients With Hidradenitis Suppurativa After an Initial Emergency Department Visit"],"prefix":"10.1001","volume":"158","author":[{"given":"Cynthia X.","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna L.","family":"Buss","sequence":"additional","affiliation":[{"name":"Institute for Informatics, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Keller","sequence":"additional","affiliation":[{"name":"Institute for Informatics, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan J.","family":"Anadkat","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"5","key":"doi220056r1","doi-asserted-by":"publisher","first-page":"S19","DOI":"10.1016\/j.jaad.2015.07.054","article-title":"The psychosocial impact of hidradenitis suppurativa.","volume":"73","author":"Gooderham","year":"2015","journal-title":"J Am Acad Dermatol"},{"issue":"3","key":"doi220056r2","doi-asserted-by":"publisher","first-page":"328","DOI":"10.2340\/00015555-1082","article-title":"Psychosocial impact of hidradenitis suppurativa: a qualitative study.","volume":"91","author":"Esmann","year":"2011","journal-title":"Acta Derm Venereol"},{"issue":"3","key":"doi220056r3","doi-asserted-by":"publisher","first-page":"264","DOI":"10.2340\/00015555-0866","article-title":"Psychophysical aspects of hidradenitis suppurativa.","volume":"90","author":"Matusiak","year":"2010","journal-title":"Acta Derm Venereol"},{"key":"doi220056r4","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.676241","article-title":"Features associated with quality of life impairment in hidradenitis suppurativa patients.","volume":"8","author":"Schneider-Burrus","year":"2021","journal-title":"Front Med (Lausanne)"},{"issue":"2","key":"doi220056r5","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.jaad.2019.06.1301","article-title":"Evaluating patients\u2019 unmet needs in hidradenitis suppurativa: results from the Global Survey Of Impact and Healthcare Needs (VOICE) project.","volume":"82","author":"Garg","year":"2020","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"doi220056r6","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1016\/j.jaad.2014.09.012","article-title":"Hidradenitis suppurativa is a systemic disease with substantial comorbidity burden: a chart-verified case-control analysis.","volume":"71","author":"Shlyankevich","year":"2014","journal-title":"J Am Acad Dermatol"},{"issue":"5","key":"doi220056r7","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.1016\/j.jaad.2015.07.055","article-title":"Systemic associations of hidradenitis suppurativa.","volume":"73","author":"Kohorst","year":"2015","journal-title":"J Am Acad Dermatol"},{"issue":"9","key":"doi220056r8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030579","article-title":"Disease burden and cost of hidradenitis suppurativa: a retrospective examination of US administrative claims data.","volume":"9","author":"Marvel","year":"2019","journal-title":"BMJ Open"},{"issue":"3","key":"doi220056r9","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.jaad.2018.02.053","article-title":"Opioid, alcohol, and cannabis misuse among patients with hidradenitis suppurativa: a population-based analysis in the United States.","volume":"79","author":"Garg","year":"2018","journal-title":"J Am Acad Dermatol"},{"issue":"2","key":"doi220056r10","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1111\/bjd.2019.181.issue-2","article-title":"Association between hidradenitis suppurativa and hospitalization for psychiatric disorders: a cross-sectional analysis of the National Inpatient Sample.","volume":"181","author":"Patel","year":"2019","journal-title":"Br J Dermatol"},{"issue":"2","key":"doi220056r11","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.jaad.2020.03.041","article-title":"The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: systematic review and meta-analysis.","volume":"83","author":"Jalenques","year":"2020","journal-title":"J Am Acad Dermatol"},{"issue":"1","key":"doi220056r12","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.jid.2017.06.020","article-title":"Patients with hidradenitis suppurativa have a high psychiatric disease burden: a Finnish nationwide registry study.","volume":"138","author":"Huilaja","year":"2018","journal-title":"J Invest Dermatol"},{"issue":"2","key":"doi220056r13","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1111\/jdv.2015.29.issue-2","article-title":"Psychiatric comorbidities in 3207 patients with hidradenitis suppurativa.","volume":"29","author":"Shavit","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"8","key":"doi220056r14","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1001\/jamadermatol.2019.0759","article-title":"Depression and anxiety in adults with hidradenitis suppurativa: a systematic review and meta-analysis.","volume":"155","author":"Machado","year":"2019","journal-title":"JAMA Dermatol"},{"issue":"8","key":"doi220056r15","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1001\/jamadermatol.2021.1677","article-title":"Prevalence of hidradenitis suppurativa: a systematic review and meta-regression analysis.","volume":"157","author":"Jfri","year":"2021","journal-title":"JAMA Dermatol"},{"issue":"5","key":"doi220056r16","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1159\/000508787","article-title":"Delayed diagnosis of hidradenitis suppurativa and its effect on patients and healthcare system.","volume":"236","author":"Kokolakis","year":"2020","journal-title":"Dermatology"},{"issue":"6","key":"doi220056r17","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1111\/bjd.14038","article-title":"Diagnostic delay in hidradenitis suppurativa is a global problem.","volume":"173","author":"Saunte","year":"2015","journal-title":"Br J Dermatol"},{"issue":"5","key":"doi220056r18","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1159\/000448515","article-title":"Hospitalisations with hidradenitis suppurativa: an increasing problem that deserves closer attention.","volume":"232","author":"Santos","year":"2016","journal-title":"Dermatology"},{"issue":"4","key":"doi220056r19","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1111\/bjd.14976","article-title":"High burden of hospital resource utilization in patients with hidradenitis suppurativa in England: a retrospective cohort study using hospital episode statistics.","volume":"176","author":"Desai","year":"2017","journal-title":"Br J Dermatol"},{"issue":"9","key":"doi220056r20","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1001\/jamadermatol.2014.691","article-title":"Health care utilization patterns and costs for patients with hidradenitis suppurativa.","volume":"150","author":"Kirby","year":"2014","journal-title":"JAMA Dermatol"},{"issue":"4","key":"doi220056r21","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/j.jaad.2015.06.053","article-title":"Increased utilization of emergency department and inpatient care by patients with hidradenitis suppurativa.","volume":"73","author":"Khalsa","year":"2015","journal-title":"J Am Acad Dermatol"},{"issue":"8","key":"doi220056r22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0255560","article-title":"Economic analysis of the costs associated with hidradenitis suppurativa at a German university hospital.","volume":"16","author":"Frings","year":"2021","journal-title":"PLoS One"},{"issue":"5","key":"doi220056r23","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1159\/000480379","article-title":"Low utilization of the dermatology ambulatory encounter among patients with hidradenitis suppurativa: a population-based retrospective cohort analysis in the USA.","volume":"233","author":"Garg","year":"2017","journal-title":"Dermatology"},{"issue":"1","key":"doi220056r24","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1111\/bjd.v184.1","article-title":"Evidence for a \u2018window of opportunity\u2019 in hidradenitis suppurativa treated with adalimumab: a retrospective, real-life multicentre cohort study.","volume":"184","author":"Marzano","year":"2021","journal-title":"Br J Dermatol"},{"issue":"1","key":"doi220056r25","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1001\/jamadermatol.2020.4494","article-title":"Pain severity and management of hidradenitis suppurativa at us emergency department visits.","volume":"157","author":"Taylor","year":"2021","journal-title":"JAMA Dermatol"},{"issue":"4","key":"doi220056r26","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1007\/s003840050159","article-title":"Extent of surgery and recurrence rate of hidradenitis suppurativa.","volume":"13","author":"Ritz","year":"1998","journal-title":"Int J Colorectal Dis"},{"issue":"1","key":"doi220056r27","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.jemermed.2021.01.022","article-title":"Relationship between pain management modality and return rates for lower back pain in the emergency department.","volume":"61","author":"Ginsberg","year":"2021","journal-title":"J Emerg Med"},{"issue":"2","key":"doi220056r28","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.21906","article-title":"Factors associated with repeat emergency department visits for low back pain.","volume":"14","author":"Megalla","year":"2022","journal-title":"Cureus"},{"issue":"11","key":"doi220056r29","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.3390\/healthcare9111470","article-title":"Risk factors for early return visits to the emergency department in patients presenting with nonspecific abdominal pain and the use of computed tomography scan.","volume":"9","author":"Yau","year":"2021","journal-title":"Healthcare (Basel)"},{"issue":"5","key":"doi220056r30","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1542\/hpeds.2020-0007","article-title":"Opioid use to treat migraine headaches in hospitalized children and adolescents.","volume":"10","author":"Masonbrink","year":"2020","journal-title":"Hosp Pediatr"},{"issue":"1","key":"doi220056r31","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jnma.2016.09.002","article-title":"Higher risk of care for hidradenitis suppurativa in African American and non-Hispanic patients in the United States.","volume":"109","author":"Udechukwu","year":"2017","journal-title":"J Natl Med Assoc"},{"issue":"8","key":"doi220056r32","doi-asserted-by":"publisher","first-page":"990","DOI":"10.2340\/00015555-2176","article-title":"Hidradenitis suppurativa disproportionately affects African Americans: a single-center retrospective analysis.","volume":"95","author":"Vlassova","year":"2015","journal-title":"Acta Derm Venereol"},{"issue":"6","key":"doi220056r33","doi-asserted-by":"publisher","DOI":"10.5070\/D3236035391","article-title":"Examining the race-specific prevalence of hidradenitis suppurativa at a large academic center; results from a retrospective chart review.","volume":"23","author":"Vaidya","year":"2017","journal-title":"Dermatol Online J"},{"issue":"1","key":"doi220056r34","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.jaad.2017.02.005","article-title":"Incidence of hidradenitis suppurativa in the United States: a sex- and age-adjusted population analysis.","volume":"77","author":"Garg","year":"2017","journal-title":"J Am Acad Dermatol"},{"issue":"9","key":"doi220056r35","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1001\/jamadermatol.2021.2999","article-title":"Racial and ethnic distribution of patients hospitalized with hidradenitis suppurativa, 2008-2018.","volume":"157","author":"Edigin","year":"2021","journal-title":"JAMA Dermatol"},{"issue":"9","key":"doi220056r36","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1001\/jamadermatol.2018.2117","article-title":"Association of low socioeconomic status with hidradenitis suppurativa in the United States.","volume":"154","author":"Wertenteil","year":"2018","journal-title":"JAMA Dermatol"},{"issue":"1","key":"doi220056r38","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1159\/000468148","article-title":"Validation of a case-finding algorithm for hidradenitis suppurativa using administrative coding from a clinical database.","volume":"233","author":"Strunk","year":"2017","journal-title":"Dermatology"},{"issue":"9","key":"doi220056r39","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1001\/jamadermatol.2021.2865","article-title":"Differences between children and adults with hidradenitis suppurativa.","volume":"157","author":"Hallock","year":"2021","journal-title":"JAMA Dermatol"},{"key":"doi220056r40","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/4980170","article-title":"Opioid prescription patterns for discharged patients from the emergency department.","volume":"2021","author":"Yanuck","year":"2021","journal-title":"Pain Res Manag"},{"issue":"1","key":"doi220056r41","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","article-title":"Comorbidity measures for use with administrative data.","volume":"36","author":"Elixhauser","year":"1998","journal-title":"Med Care"},{"issue":"12","key":"doi220056r44","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1016\/S0895-4356(00)00256-0","article-title":"Development of a comorbidity index using physician claims data.","volume":"53","author":"Klabunde","year":"2000","journal-title":"J Clin Epidemiol"},{"issue":"2","key":"doi220056r45","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1001\/jamadermatol.2020.5173","article-title":"Insurance acceptance, appointment wait time, and dermatologist access across practice types in the US.","volume":"157","author":"Creadore","year":"2021","journal-title":"JAMA Dermatol"},{"issue":"2","key":"doi220056r46","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.jaad.2021.09.046","article-title":"A cross-sectional analysis of Medicaid acceptance among US dermatology residency training programs.","volume":"86","author":"Williams","year":"2022","journal-title":"J Am Acad Dermatol"},{"issue":"11","key":"doi220056r48","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1001\/jamadermatol.2018.3022","article-title":"Comparison of dermatologist density between urban and rural counties in the United States.","volume":"154","author":"Feng","year":"2018","journal-title":"JAMA Dermatol"},{"issue":"4","key":"doi220056r49","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1001\/jamadermatol.2016.5411","article-title":"Analysis of trends in geographic distribution and density of US dermatologists.","volume":"153","author":"Glazer","year":"2017","journal-title":"JAMA Dermatol"},{"issue":"4","key":"doi220056r50","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.ajem.2019.06.011","article-title":"Trends in emergency physician opioid prescribing practices during the United States opioid crisis.","volume":"38","author":"Gleber","year":"2020","journal-title":"Am J Emerg Med"},{"key":"doi220056r37","unstructured":"IBM. IBM MarketScan Research Databases. Accessed April 15, 2022. https:\/\/www.ibm.com\/products\/marketscan-research-databases\/databases"},{"key":"doi220056r42","unstructured":"Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project clinical classifications software for ICD-9-CM. Accessed December 17, 2021. http:\/\/www.hcup-us.ahrq.gov\/toolssoftware\/ccs\/ccs.jsp"},{"key":"doi220056r43","unstructured":"Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project Elixhauser comorbidity software, version 3.7. Accessed December 17, 2021. http:\/\/www.hcup-us.ahrq.gov\/toolssoftware\/comorbidity\/comorbidity.jsp"},{"key":"doi220056r47","unstructured":"Guth? M, Artiga? S. Medicaid and racial health equity. Kaiser Family Foundation. March 17, 2022. Accessed April 21, 2022. https:\/\/www.kff.org\/medicaid\/issue-brief\/medicaid-and-racial-health-equity\/"}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2797839\/jamadermatology_wang_2022_oi_220056_1670609086.64013.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T11:10:27Z","timestamp":1671621027000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2797839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,1]]},"references-count":50,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2022.4610","relation":{},"ISSN":["2168-6068"],"issn-type":[{"value":"2168-6068","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12,1]]}}}