The financial impact and utilization of inpatient dermatology services: historical insights and future implications

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.