Little is known about the impact of primary melanoma diagnosis on healthcare utilization and changes in utilization over time.
To evaluate population‐based temporal trends in healthcare utilization following primary melanoma diagnosis.
We conducted a before‐and‐after multiple time series study of Medicare beneficiaries aged ≥ 66 years with primary melanoma diagnoses between 2000 and 2009 using the Surveillance, Epidemiology, and End Results Medicare database. Primary exposure was time from primary melanoma diagnosis at 3–6 months and 6–24 months postdiagnosis. Covariates included tumour‐, patient‐ and geographical‐level characteristics and healthcare utilization in the 6 months before diagnosis. Poisson regression was used to estimate population‐based risk‐adjusted utilization rates for skin biopsies, benign skin excisions, internal medicine office visits and dermatology office visits.
The study population included 56 254 patients with first diagnoses of primary melanoma. Most patients were ≥ 75 years old (56·8%), male (62·1%), and had in situ melanoma (42·4%) or localized invasive melanoma (45·9%). From 2000 to 2009, risk‐adjusted skin biopsy rates 24 months postdiagnosis increased from 358·3 to 541·3 per 1000 person‐years (P < 0·001), and dermatology visits increased from 989·0 to 1535·6 per 1000 person‐years (P < 0·001). Benign excisions and internal medicine visits remained stable. In 2000, risk‐adjusted skin biopsy rates 6 months postdiagnosis increased by 208·5 relative to the 6 months before diagnosis (148·7 vs. 357·2) compared with an observed absolute increase of 272·5 (290·9 vs. 563·1) in 2009. Trends in dermatology visits were similar.
Utilization of skin biopsies and dermatology office visits following primary melanoma diagnosis has increased substantially over time. These results may inform optimization of care delivery for melanoma within the Medicare population.
05 Dec 2019
RT The British Association of Dermatologists @HealthySkin4All: The authors of this @BrJDermatol study have described factors which could help doctors to identify children with eczema at a higher risk of eczema continuing into adulthood. https://t.co/ZNNzE7iZ4h @eczemasociety @eczemasupport @EczemaOutreach @Wiley_Health https://t.co/2ADGsWtDAY
04 Dec 2019
04 Dec 2019
In #psoriasis how does the #microbiome differ in #lesional skin compared to normal skin and controls? Results from standard culture and 16S RNA sequencing: https://t.co/5IvWYjltcn https://t.co/abvf9cbvUl
03 Dec 2019
RT EPI-PHARE @EPIPHARE: Des membres d'EPI-PHARE ont publié un article dans British Journal of Dermatology [EN] New article from EPI-PHARE members in @BrJDermatol ➡️ Persistence of treatment with conventional systemic agents for patients with #psoriasis... 🔗 https://t.co/WKcPUhs4Io https://t.co/0GDaE7byHy