Dermatology urgent care model reduces costs and healthcare utilization for psychodermatology patients'a retrospective chart review

Background: Patients with psychiatric dermatoses may be high users of healthcare, especially emergency services. A dermatology urgent care model may reduce healthcare utilization in this population. Objective: To determine whether a dermatology urgent care model can reduce healthcare utilization among patients with psychiatric dermatoses. Methods: We conducted a retrospective chart review of patients seen in dermatology urgent care at Oregon Health and Science University between 2018 and 2020 with diagnoses of Morgellons disease and neurotic excoriations. Rates of diagnosis-related healthcare visits and emergency department visits were annualized before and during engagement with the dermatology department. Rates were compared using paired t-tests. Results: We found an 88.0% reduction in annual rates of healthcare visits (P<0.001) and 77.0% reduction in emergency room visits (P<0.003). Results were unchanged when controlled for gender identity, diagnosis, and substance use. Limitations: We could not account for healthcare use not included in electronic health record. Conclusion: Urgent care models in dermatology may reduce overuse of healthcare and emergency services among patients with psychiatric dermatoses.