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Outpatient Utilization Patterns for AD in the US

J Am Acad Dermatol; ePub 2019 Mar 15; Singh, et al

Among US adults and children, outpatient visits for atopic dermatitis (AD) have increased over time but decreased for dermatologists. Data from the 1993-2015 National Ambulatory Medical Care Survey were analyzed, including 110,095 pediatric and 642,140 adult outpatient visits. Researchers sought to determine the trends and determinants of outpatient healthcare utilization for AD in this population group. They found:

  • AD visits occurred predominantly in primary care providers (PCPs), followed by dermatologist and allergists.
  • The frequency of AD visits increased from 1996-1999 to 2012-2015 overall, particularly among PCPs.
  • The frequency of AD visits to dermatologists decreased.
  • AD visits were most common among children aged 0‒4 years.
  • AD visits were more likely to be acute visits among PCPs and chronic among dermatologists.


Singh P, Silverberg JL. Outpatient utilization patterns for atopic dermatitis in the United States. [Published online ahead of print March 15, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.03.021.


It has been known for some time that the prevalence of atopy is increasing, especially in industrialized countries. The number of dermatologists, however seems to be fairly static. It should probably not come as a surprise that while the number of outpatient visits for AD has increased over the last 10 years or so, more of the increase has been seen by primary care practitioners. This suggests that increased training in AD management for PCPs will be important to optimize care for those patients not seeing a dermatologist.
Joseph Fowler, Jr., MD, Clinical Professor of Dermatology, University of Louisville, KY