Changes in health care delivery have led to a reduction in the number of patients admitted to academic dermatology inpatient units.<sup>2 Kirsner R.S., Yang D.G., Kerdel F.A. The changing status of inpatient dermatology at American Academic Dermatology Programs J Am Acad Derm 1999 ;  40 : 755-757  [cross-ref]

Cliquez ici pour aller à la section Références</sup> Despite this reduction, many patients with skin disease are hospitalized annually, and severe skin disease may affect patients regardless of their insurance status.<sup>3 Kirsner R.S., Yang D.G., Kerdel F.A. Dermatologic disease accounts for many admissions nationally J Am Acad Derm 1999 ;  41 : 990-997

Cliquez ici pour aller à la section Références</sup> In an effort to determine the effect of various health care delivery systems on hospitalizations for severe skin disease, the authors examined demographic characteristics and analyzed the effect of payers on admissions to an active inpatient dermatology service.

The University of Miami (UM) Department of Dermatology and Cutaneous Surgery, affiliated with Jackson Memorial Hospital, maintains an active inpatient dermatology service located in a private hospital (Cedars Medical Center). Jackson Memorial Hospital is the only county hospital for Miami-Dade County, and patients may be admitted to the UM Dermatology Service from Jackson Memorial Hospital emergency departments or dermatology clinics. UM is the only academic medical center in South Florida, and as such, patients are also admitted by UM dermatology faculty and community dermatologists.

Using this setting, the effect of health care delivery on admissions to a dermatology inpatient unit was examined. Specifically the authors (1) wished to study the characteristics of patients admitted to an inpatient dermatology unit, (2) determine if and how lengths of stay differ depending on the diagnosis and payer type, (3) detect differences in case-mix index for the different payers, and (4) evaluate differences in resource use allocation.