DOI: 10.4103/jpds.jpds_4_26 ISSN: 2094-201X

Relationship of Atopic Dermatitis Severity with Out-of-Pocket Costs, Perceived Financial Burden, and Work Productivity Among Adult Patients in a Tertiary Hospital in the Philippines: A Cross-Sectional Study

Alyanna Jean E. Dela Cruz, Danielle Nicolle Dionisio Mejia

Abstract

Context:

Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with significant financial costs and impaired productivity. While its impact has been explored globally, local data on the relationship between AD severity, patient-reported costs, and productivity impairment remain limited.

Aims:

The study aimed to determine the relationship between AD severity and patient-reported out-of-pocket (OOP) costs, perceived financial burden, and productivity impairment among adult patients.

Materials and Methods:

A cross-sectional study was conducted among adult patients with AD in an outpatient setting. Adults aged 19–59 years were enrolled. Disease severity was assessed using the SCORing AD (SCORAD) Index. Patient-reported OOP costs, productivity impairment, and perceived financial burden were evaluated using a Filipino OOP Costs Questionnaire and the Work Productivity and Activity Impairment–General Health Questionnaire. Data were summarized using the descriptive statistics. Differences across severity groups were analyzed using the Kruskal–Wallis H -test, and associations between SCORAD severity and OOP costs or productivity loss were assessed using Spearman rank correlation. Statistical significance was set at P < 0.05.

Results:

Sixty-seven participants were included, the majority of whom had moderate AD. Treatment costs significantly correlated with disease severity ( r = 0.383, P = 0.018). Work impairment increased significantly with greater disease severity ( r = 0.245, P = 0.045). Activity impairment was observed across all severity levels, while medication, transportation, and other costs were not significantly associated with severity.

Conclusions:

Greater AD severity is associated with higher OOP costs, increased perceived financial burden, and reduced work productivity, particularly among patients with moderate-to-severe disease.

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