Ethnic Minorities and Men Less Likely to See a Dermatologist
Patients who visit a dermatologist are more likely to be white, female, and/or have a higher education level and income, according to the findings of a recent study.
“Equitable access to dermatologists is a critical component of comprehensive care, and better understanding the differences in use of outpatient dermatologic care by various socioeconomic and demographic groups is a key step in improving the overall health of Americans,” the researchers said.
In the retrospective study, the researchers analyzed data from the 2007 to 2015 Medical Expenditure Panel Survey (MEPS), which was provided by the Agency for Healthcare Research and Quality. A total of 183,054 participants who visited a dermatologist were identified (mean age 34 years; 52.1% were female).
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The primary outcome included whether a patient received outpatient care for any dermatologic condition, such as skin cancers, infections, inflammatory skin conditions or ulcers, and other skin disorders. Secondary outcomes included annual health care use by individuals with dermatologic conditions. Analyses accounted for sex, age, race/ethnicity, education level, income, insurance status, region, self-reported skin condition, and self-reported health status.
Overall, 19,561 (10.7%) participants reported they had a dermatologic condition, and 9645 had a total of 11,761 outpatient visits to dermatologists.
Hispanic or black participants were less likely to receive outpatient care for their dermatologic condition compared with non-Hispanic white participants (adjusted odds ratio [aOR] 0.55, 95% CI 0.49-0.61 and aOR 0.42, 95% CI 0.38-0.46, respectively). Likewise, male participants were less likely than female participants to receive dermatologic care (aOR 0.66, 95% CI 0.62-0.70).
Disparities were also found based on region as participants from the Midwest were less likely to receive dermatologic care compared with those from the Northeast (aOR 0.80, 95% CI 0.70-0.91). In addition, participants with Medicaid or Medicare coverage (aOR, 0.75; 95% CI, 0.68-0.83) or who were uninsured (aOR, 0.39; 95% CI, 0.33-0.47) were less likely to receive outpatient dermatologic care compared with privately insured participants.
The researchers also found that increasing educational level and income were associated with higher odds of receiving outpatient care for dermatologic conditions.
“Results of this study suggest an urgent need to further characterize potential dermatologic health care differences and improve use of outpatient dermatologic care among disadvantaged populations,” the researchers concluded.
Tripathi R, Knusel KD, Ezaldein HH, Scott JF, Bordeaux JS. Association of demographic and socioeconomic characteristics with differences in use of outpatient dermatology services in the United States [published online September 26, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2018.3114