Trends in healthcare utilization for infantile haemangioma in the U.S.A.

TY - JOUR

T1 - Trends in healthcare utilization for infantile haemangioma in the U.S.A.

AU - Singh, P.

AU - Chamlin, S.

AU - Hignett, E.

AU - Silverberg, J. I.

N1 - Funding Information: P. Singh S. Chamlin E. Hignett J.I. Silverberg JonathanISilverberg@gmail.com Department of Dermatology Northwestern University Chicago IL U.S.A Department of Pediatrics Northwestern University Chicago IL U.S.A Department of Dermatology, Preventive Medicine and Medical Social Sciences Feinberg School of Medicine Northwestern University Chicago IL U.S.A Funding sources: this publication was made possible with support from the Dermatology Foundation. Conflicts of interest: none to declare. Most haemangiomas follow a predictable pattern with proliferation followed by slow involution, and many do not require medical or surgical intervention. However, some haemangiomas cause complications, including disfigurement, visual obstruction and/or functional impairment, which require therapeutic intervention. Since the discovery of beta blockers as effective topical and oral therapy for IH, haemangioma specialists have suggested early therapy and referral for IH to prevent permanent sequalae. However, little is known about utilization patterns for haemangiomas in the U.S.A. Dear Editor, Infantile haemangiomas (IHs) are the most common vascular tumour of infancy. We examined outpatient visits in young children (age ≤ 2 years) for haemangiomas [International Classification of Diseases 9th Revision diagnostic codes 228·01 (cutaneous) or combined 228·00, 228·01 and 228·09 (any)] in the 1993–2015 National Ambulatory Medicare Care Survey (NAMCS). NAMCS is implemented by the National Center for Health Statistics and uses a multistage estimation procedure using survey weights to adjust for nonresponse and to allow for nationally representative estimates. All analyses were performed in Stata (version 14·2; StataCorp LLC, College Station, TX, U.S.A.) and accounted for study design and weights. Weighted frequencies, proportions and 95% confidence intervals (CIs) were estimated. Trends of visits over time were examined using 6‐ or 7‐year bins in order to minimize standard error. Visits for any haemangioma increased from 627 886 (95% CI 225 301–1 030 471) in 1993–2000 to 937 174 (95% CI 506 921–1 367 427) in 2001–2008 and 1 319 877 (95% CI 725 426–1 914 328) in 2009–2015 ( P = 0·03). However, visits for cutaneous haemangioma marginally significantly increased between 1993–2000 (132 711, 95% CI 0–280 137), 2001–2008 (278 366, 95% CI 13 837–542 895) and 2009–2015 (515 565, 95% CI 146 487–884 644) ( P  = 0·06). Visits with a diagnosis of any (8·6%, 95% CI 4·6–15·6, P < 0·001) and cutaneous haemangioma (9·1%, 95% CI 3·4–22·5, ; full data available on request). Furthermore, visits with a diagnosis of any (65·1%, 95% CI 50·1–77·6, P < 0·001) were significantly more likely to be managed by a dermatologist compared with visits without any haemangioma (0·4%, 95% CI 0·4–0·5) (Table  P  = 0·02) and cutaneous haemangioma (75·3%, 95% CI 4·1–88·8, P  = 0·007) were more likely to be in girls compared with those without haemangioma (47·1%, 95% CI 46·4–47·7). There were no significant differences of haemangioma visits by race/ethnicity, geographical region, season or insurance type.

PY - 2020/2/1

Y1 - 2020/2/1

UR - http://www.scopus.com/inward/record.url?scp=85074836168&partnerID=8YFLogxK

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U2 - 10.1111/bjd.18513

DO - 10.1111/bjd.18513

M3 - Letter

C2 - 31505043

AN - SCOPUS:85074836168

SN - 0007-0963

VL - 182

SP - 509

EP - 511

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 2

ER -