{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:09:36Z","timestamp":1793747376403,"version":"4.6.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T00:00:00Z","timestamp":1738972800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T00:00:00Z","timestamp":1738972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Dermatol Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Skin diseases affect millions of Americans, imposing a large financial burden on the U.S. healthcare system annually. Inpatient dermatology is a subspecialty focused on treating complicated skin diseases in hospitalized patients. Utilization of these services enhances diagnostic accuracy, shorten hospital stays, lower readmission rates, and improve patient outcomes. However, studies have indicated an overall decline in inpatient dermatology consultations and dermatology as primary admitting services. Currently, only two academic hospitals in the United States grant dermatologists admitting privileges, indicating decreased exposure to inpatient dermatology in residency despite the need for more hospital-based dermatologists. Therefore, this narrative review aims to characterize the financial impact and utilization of inpatient dermatology services. Historical and recent data consistently highlight the financial benefit of dermatologic hospitalizations and poor utilization of inpatient dermatology consultations. Teledermatology consultations also improve diagnostic accuracy and expedite interventions to improve patient outcomes. However, challenges like reduced reimbursement, lack of protocols, and limited resident training in inpatient dermatology have discouraged dermatologists from providing inpatient consultations. Policy changes are needed to promote these services that benefit patients as well as health systems.<\/jats:p>","DOI":"10.1007\/s00403-025-03867-y","type":"journal-article","created":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T14:47:16Z","timestamp":1739026036000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The financial impact and utilization of inpatient dermatology services: historical insights and future implications"],"prefix":"10.1007","volume":"317","author":[{"given":"Olivia","family":"Burke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Hartoyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Kirsner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Elman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,8]]},"reference":[{"issue":"8","key":"3867_CR1","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1001\/jamadermatol.2020.1573","volume":"156","author":"MR Laughter","year":"2020","unstructured":"Laughter MR et al (2020) The Burden of skin and Subcutaneous diseases in the United States from 1990 to 2017. JAMA Dermatol 156(8):874\u2013881","journal-title":"JAMA Dermatol"},{"issue":"2","key":"3867_CR2","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.jaad.2018.06.070","volume":"80","author":"JD Arnold","year":"2019","unstructured":"Arnold JD, Yoon S, Kirkorian AY (2019) The national burden of inpatient dermatology in adults. J Am Acad Dermatol 80(2):425\u2013432","journal-title":"J Am Acad Dermatol"},{"issue":"8","key":"3867_CR3","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1001\/archderm.1994.01690080088013","volume":"130","author":"V Falanga","year":"1994","unstructured":"Falanga V et al (1994) Dermatologic consultations in the hospital setting. Arch Dermatol 130(8):1022\u20131025","journal-title":"Arch Dermatol"},{"issue":"2","key":"3867_CR4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.5070\/D364H8J3KZ","volume":"16","author":"M Davila","year":"2010","unstructured":"Davila M, Christenson LJ, Sontheimer RD (2010) Epidemiology and outcomes of dermatology in-patient consultations in a Midwestern U.S. university hospital. Dermatol Online J 16(2):12","journal-title":"Dermatol Online J"},{"issue":"4","key":"3867_CR5","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1001\/jamadermatol.2015.5098","volume":"152","author":"D Kroshinsky","year":"2016","unstructured":"Kroshinsky D et al (2016) Association of Dermatology Consultation with Accuracy of cutaneous disorder diagnoses in hospitalized patients: a Multicenter Analysis. JAMA Dermatol 152(4):477\u2013480","journal-title":"JAMA Dermatol"},{"issue":"5","key":"3867_CR6","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1001\/jamadermatol.2017.6196","volume":"154","author":"LN Ko","year":"2018","unstructured":"Ko LN et al (2018) Effect of Dermatology Consultation on outcomes for patients with presumed cellulitis: a Randomized Clinical Trial. JAMA Dermatol 154(5):529\u2013536","journal-title":"JAMA Dermatol"},{"issue":"6","key":"3867_CR7","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1001\/jamadermatol.2016.6130","volume":"153","author":"N Milani-Nejad","year":"2017","unstructured":"Milani-Nejad N, Zhang M, Kaffenberger BH (2017) Association of Dermatology Consultations with Patient Care outcomes in hospitalized patients with inflammatory skin diseases. JAMA Dermatol 153(6):523\u2013528","journal-title":"JAMA Dermatol"},{"issue":"3","key":"3867_CR8","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.thorsurg.2017.03.006","volume":"27","author":"RL Medbery","year":"2017","unstructured":"Medbery RL, Force SD (2017) Quality and cost in thoracic surgery. Thorac Surg Clin 27(3):267\u2013277","journal-title":"Thorac Surg Clin"},{"issue":"4","key":"3867_CR9","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1016\/j.jaad.2018.03.042","volume":"79","author":"JD Arnold","year":"2018","unstructured":"Arnold JD, Crockett RM, Kirkorian AY (2018) Hospital readmissions among patients with skin disease: a retrospective cohort study. J Am Acad Dermatol 79(4):696\u2013701","journal-title":"J Am Acad Dermatol"},{"issue":"5 Pt 1","key":"3867_CR10","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1016\/S0190-9622(99)70158-1","volume":"40","author":"RS Kirsner","year":"1999","unstructured":"Kirsner RS, Yang DG, Kerdel FA (1999) The changing status of inpatient dermatology at American academic dermatology programs. J Am Acad Dermatol 40(5 Pt 1):755\u2013757","journal-title":"J Am Acad Dermatol"},{"issue":"4","key":"3867_CR11","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1111\/pde.12081","volume":"30","author":"ER Storan","year":"2013","unstructured":"Storan ER et al (2013) Pediatric hospital dermatology: experience with inpatient and consult services at the Mayo Clinic. Pediatr Dermatol 30(4):433\u2013437","journal-title":"Pediatr Dermatol"},{"issue":"5","key":"3867_CR12","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1111\/pde.13549","volume":"35","author":"JD Arnold","year":"2018","unstructured":"Arnold JD, Yoon S, Kirkorian AY (2018) Inpatient burden of pediatric dermatology in the United States. Pediatr Dermatol 35(5):602\u2013606","journal-title":"Pediatr Dermatol"},{"issue":"3","key":"3867_CR13","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1016\/j.jaad.2019.05.023","volume":"81","author":"M Zhang","year":"2019","unstructured":"Zhang M et al (2019) Dermatology-specific and all-cause 30-day and calendar-year readmissions and costs for dermatologic diseases from 2010 to 2014. J Am Acad Dermatol 81(3):740\u2013748","journal-title":"J Am Acad Dermatol"},{"issue":"1","key":"3867_CR14","doi-asserted-by":"publisher","first-page":"23","DOI":"10.12788\/cutis.0806","volume":"112","author":"M Moumen","year":"2023","unstructured":"Moumen M, Strowd LC (2023) Palliative Care: utilization patterns in Inpatient Dermatology. Cutis 112(1):23\u201325","journal-title":"Cutis"},{"issue":"12","key":"3867_CR15","doi-asserted-by":"publisher","first-page":"e936","DOI":"10.1111\/jdv.17595","volume":"35","author":"P Puri","year":"2021","unstructured":"Puri P et al (2021) Evaluating the potential cost savings from inpatient dermatology consultations. J Eur Acad Dermatol Venereol 35(12):e936\u2013e938","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"4","key":"3867_CR16","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s00403-024-02845-0","volume":"316","author":"JA Hydol-Smith","year":"2024","unstructured":"Hydol-Smith JA et al (2024) The United States dermatology inpatient workforce between 2013 and 2019: a Medicare analysis reveals contraction of the workforce and vast access deserts-a cross-sectional analysis. Arch Dermatol Res 316(4):103","journal-title":"Arch Dermatol Res"},{"issue":"2","key":"3867_CR17","doi-asserted-by":"publisher","first-page":"100","DOI":"10.36469\/jheor.2023.89151","volume":"10","author":"APB de Silva Etges","year":"2023","unstructured":"de Silva Etges APB et al (2023) Value-based reimbursement as a mechanism to Achieve Social and Financial Impact in the Healthcare System. J Health Econ Outcomes Res 10(2):100\u2013103","journal-title":"J Health Econ Outcomes Res"},{"issue":"3","key":"3867_CR18","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1111\/j.1600-0447.1987.tb02904.x","volume":"76","author":"JM Eagles","year":"1987","unstructured":"Eagles JM (1987) Decreasing rates of diagnoses of schizophrenia in Denmark. Acta Psychiatr Scand 76(3):333\u2013336","journal-title":"Acta Psychiatr Scand"},{"issue":"6","key":"3867_CR19","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1016\/j.jaad.2023.01.021","volume":"88","author":"P Puri","year":"2023","unstructured":"Puri P et al (2023) Association of society of dermatology hospitalist institutions with improved outcomes in Medicare beneficiaries hospitalized for skin disease. J Am Acad Dermatol 88(6):1372\u20131375","journal-title":"J Am Acad Dermatol"},{"issue":"7","key":"3867_CR20","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1089\/tmj.2019.0147","volume":"26","author":"C Georgesen","year":"2020","unstructured":"Georgesen C et al (2020) Inpatient eDermatology (Teledermatology) can help meet the demand for Inpatient skin disease. Telemed J E Health 26(7):872\u2013878","journal-title":"Telemed J E Health"},{"issue":"5","key":"3867_CR21","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1016\/j.jaad.2020.01.030","volume":"82","author":"JJ Keller","year":"2020","unstructured":"Keller JJ, Johnson JP, Latour E (2020) Inpatient teledermatology: diagnostic and therapeutic concordance among a hospitalist, dermatologist, and teledermatologist using store-and-forward teledermatology. J Am Acad Dermatol 82(5):1262\u20131267","journal-title":"J Am Acad Dermatol"},{"key":"3867_CR22","doi-asserted-by":"crossref","unstructured":"Hines AS et al (2021) Retrospective analysis of 450 emergency department dermatology consultations: an analysis of in-person and teledermatology consultations from 2015 to 2019. J Telemed Telecare,: p. 1357633x211024844","DOI":"10.1177\/1357633X211024844"},{"issue":"8","key":"3867_CR23","doi-asserted-by":"publisher","first-page":"2449","DOI":"10.1007\/s00403-023-02637-y","volume":"315","author":"L Zheng","year":"2023","unstructured":"Zheng L et al (2023) Perceptions of telehealth among inpatient consultative dermatology providers and practice patterns during COVID-19. Arch Dermatol Res 315(8):2449\u20132451","journal-title":"Arch Dermatol Res"},{"issue":"3","key":"3867_CR24","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1016\/j.jaad.2019.07.013","volume":"83","author":"EA Weig","year":"2020","unstructured":"Weig EA et al (2020) Inpatient teledermatology: current state and practice gaps. J Am Acad Dermatol 83(3):797\u2013802","journal-title":"J Am Acad Dermatol"},{"issue":"4","key":"3867_CR25","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1089\/153056203772744671","volume":"9","author":"JD Whited","year":"2003","unstructured":"Whited JD et al (2003) An economic analysis of a store and forward teledermatology consult system. Telemed J E Health 9(4):351\u2013360","journal-title":"Telemed J E Health"},{"issue":"9","key":"3867_CR26","doi-asserted-by":"publisher","first-page":"e868","DOI":"10.1097\/GOX.0000000000000826","volume":"4","author":"JT Chen","year":"2016","unstructured":"Chen JT, Kempton SJ, Rao VK (2016) The Economics of skin Cancer: an analysis of Medicare Payment Data. Plast Reconstr Surg Glob Open 4(9):e868","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"5","key":"3867_CR27","first-page":"e4586","volume":"11","author":"KP Schrom","year":"2019","unstructured":"Schrom KP et al (2019) Utilization and cost of Inpatient dermatologic procedures: a cross-sectional analysis. Cureus 11(5):e4586","journal-title":"Cureus"},{"key":"3867_CR28","unstructured":"Centers for Medicare & Medicaid Services. Medicare Physician Fee Schedule Search (2024); Available from: https:\/\/www.cms.gov\/medicare\/physician-fee-schedule"},{"issue":"5","key":"3867_CR29","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/s00403-024-02924-2","volume":"316","author":"S Balboul","year":"2024","unstructured":"Balboul S, Gronbeck C, Feng H (2024) Dermatology workforce projections in the United States, 2021 to 2036. Arch Dermatol Res 316(5):192","journal-title":"Arch Dermatol Res"},{"key":"3867_CR30","doi-asserted-by":"crossref","unstructured":"Giesey R et al (2018) A pilot program for community dermatologists working with primary care residents to provide dermatology consults to a regional hospital. Dermatol Online J, 24(1)","DOI":"10.5070\/D3241037924"},{"issue":"1","key":"3867_CR31","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.jaad.2020.08.044","volume":"85","author":"CS Zhong","year":"2021","unstructured":"Zhong CS et al (2021) Revenue generation of dermatology inpatient consultations: a retrospective multi-institutional evaluation of academic hospital-based consults. J Am Acad Dermatol 85(1):275\u2013276","journal-title":"J Am Acad Dermatol"},{"issue":"1","key":"3867_CR32","doi-asserted-by":"publisher","first-page":"23","DOI":"10.7861\/futurehosp.4-1-23","volume":"4","author":"JLC Wong","year":"2017","unstructured":"Wong JLC, Vincent RC, Al-Sharqi A (2017) Dermatology consultations: how long do they take? Future Hosp J 4(1):23\u201326","journal-title":"Future Hosp J"},{"issue":"7244","key":"3867_CR33","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1136\/bmj.320.7244.1252","volume":"320","author":"R Wootton","year":"2000","unstructured":"Wootton R et al (2000) Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis. BMJ 320(7244):1252\u20131256","journal-title":"BMJ"},{"issue":"7406","key":"3867_CR34","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1136\/bmj.327.7406.84","volume":"327","author":"PB Jacklin","year":"2003","unstructured":"Jacklin PB et al (2003) Virtual outreach: economic evaluation of joint teleconsultations for patients referred by their general practitioner for a specialist opinion. BMJ 327(7406):84","journal-title":"BMJ"},{"issue":"1","key":"3867_CR35","doi-asserted-by":"publisher","first-page":"35","DOI":"10.2340\/00015555-1876","volume":"95","author":"N Nami","year":"2015","unstructured":"Nami N et al (2015) Concordance and time estimation of store-and-forward mobile teledermatology compared to classical face-to-face consultation. Acta Derm Venereol 95(1):35\u201339","journal-title":"Acta Derm Venereol"},{"issue":"8","key":"3867_CR36","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/S1473-3099(22)00360-7","volume":"22","author":"G El Helou","year":"2022","unstructured":"El Helou G et al (2022) Infectious diseases compensation in the USA: the relative value. Lancet Infect Dis 22(8):1106\u20131108","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"3867_CR37","doi-asserted-by":"publisher","first-page":"28","DOI":"10.12788\/j.sder.2017.003","volume":"36","author":"L Afifi","year":"2017","unstructured":"Afifi L, Shinkai K (2017) Optimizing education on the inpatient dermatology consultative service. Semin Cutan Med Surg 36(1):28\u201334","journal-title":"Semin Cutan Med Surg"},{"issue":"8","key":"3867_CR38","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1111\/ijd.13876","volume":"57","author":"Y Xue","year":"2018","unstructured":"Xue Y, Rana J, Burgin S (2018) Teaching & Learning Tips 10: Interspecialty teaching through inpatient dermatology consults. Int J Dermatol 57(8):985\u2013988","journal-title":"Int J Dermatol"},{"issue":"2","key":"3867_CR39","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1177\/12034754211045393","volume":"26","author":"F Mahmood","year":"2022","unstructured":"Mahmood F et al (2022) Teledermatology utilization and integration in Residency Training over the COVID-19 pandemic. J Cutan Med Surg 26(2):135\u2013142","journal-title":"J Cutan Med Surg"}],"container-title":["Archives of Dermatological Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00403-025-03867-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00403-025-03867-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00403-025-03867-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T14:47:22Z","timestamp":1739026042000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00403-025-03867-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,8]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3867"],"URL":"https:\/\/doi.org\/10.1007\/s00403-025-03867-y","relation":{},"ISSN":["1432-069X"],"issn-type":[{"value":"1432-069X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,8]]},"assertion":[{"value":"22 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"374"}}