GENERAL DERMATOLOGY

Temporal trends in healthcare utilization following primary melanoma diagnosis among Medicare beneficiaries

Commentary or Editorial available

Plain Language Summary available

Article first published online: 09 Jul 2017
DOI: 10.1111/bjd.15530

Comment on this article

Summary

Background

Little is known about the impact of primary melanoma diagnosis on healthcare utilization and changes in utilization over time.

Objectives

To evaluate population‐based temporal trends in healthcare utilization following primary melanoma diagnosis.

Methods

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.

Results

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.

Conclusions

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.

Read moreRead more (PDF)

Share this article

0

Favourite

Comments

If you want to submit a letter for publication rather than comment on an article please submit through Scholar One: https://mc.manuscriptcentral.com/bjd

There are no comments for this article yet.

Recent Tweets

@BrJDermatol

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

@BrJDermatol

04 Dec 2019

The December issue of @BrJDermatol is out now! https://t.co/5k5nitO7lx https://t.co/XeGa1M69uC

@BrJDermatol

04 Dec 2019

RT The British Association of Dermatologists @HealthySkin4All: You can stay up to date with all the latest research from the @BrJDermatol by reading the free plain language summaries of research online here: https://t.co/SY2AkPpw61 https://t.co/gaNkextAJj

@BrJDermatol

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

@BrJDermatol

03 Dec 2019

Watch this video about developing and validating the PP-NRS (Peak Pruritus Numerical Rating Scale), a psychometric test for assessing the intensity of #itch in patients with #AtopicDermatitis : https://t.co/c0UXDaxeC6

@BrJDermatol

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

Close