Do Racial Minorities with Psoriasis Seek Treatment Less Often?
For their study, Alexander H. Fischer, MD, MPH, and colleagues assessed 842 individuals with psoriasis using 2001-2013 data from the Medical Expenditure Panel Survey. Patients were classified by race/ethnicity, with categories including non-Hispanic whites (reference), Hispanic whites, and non-Hispanic minorities.
Health care utilization outcomes, which included the number of ambulatory visits, the number of prescriptions, and any ambulatory visits for psoriasis, were assessed. Using multivariable regression, the independent association between race/ethnicity and each of these outcomes was examined.
A total of 842 participants reported having psoriasis, which corresponded to more than 1.6 million individuals with self-reported psoriasis in the United States. Results of the study revealed that non-Hispanic racial minorities had reported fewer ambulatory visits for psoriasis compared with non-Hispanic whites, with an incidence rate ratio of 0.54. Ultimately, this equated to an absolute difference of 1.24 fewer visits per person per year and more than 3 million fewer visits per year among non-Hispanic racial minorities with psoriasis vs non-Hispanic whites.
In addition, the likelihood of seeing a dermatologist for psoriasis was found to be lower among non-Hispanic minorities vs non-Hispanic whites, with an odds ratio of 0.59. However, the researchers noted, the number of prescriptions obtained for psoriasis did not differ significantly between racial/ethnic groups.
“Our new identification of disparities in ambulatory health care utilization for psoriasis among non-Hispanic minorities is particularly notable in light of previous data suggesting that racial/ethnic minorities have more severe psoriasis and poorer quality of life because of their skin disease compared with whites,” the researchers concluded. “Additional studies to understand why differences in health care utilization exist are necessary to achieve equitable care for all patients with psoriasis.”
Fischer AH, Shin DB, Gelfand JM, Takeshita J. Health care utilization for psoriasis in the United States differs by race: an analysis of the 2001-2013 Medical Expenditure Panel Surveys. J Am Acad Dermatol. 2018;78(1):200-203. http://dx.doi.org/10.1016/j.jaad.2017.07.052.