The changing status of inpatient dermatology at American academic dermatology programs

Background: Changes in health care delivery financing such as the adoption of the diagnosis-related groups (DRG) in 1983 has affected inpatient servic es of dermatology programs across the United States. Objective: The purpose of this study was to define the present status of in patient dermatology at academic medical centers compared with 1982. Methods: Questionnaires inquiring about the state of inpatient service were sent to the chairpersons of each dermatology residency program in the Unit ed States. Results: Of the 71 programs responding, 79% reported a reduction in inpatie nt activity. Nearly half of the dermatology programs with dedicated dermato logy beds in 1982 reported not continuing to have these in 1997 (41 to 24). The average number of patients admitted for skin disease decreased from 11 9 in 1982 to 36.5 in 1997, and the average daily census decreased from 8.9 to 2.2. Conclusion: There has been a decline in the number of patients hospitalized by academic dermatology departments and a shift of some patients hospitali zed to beds where the attending is other than a dermatologist.