Tripathi R, et al. - Researchers assessed the differences in use of dermatologic care in the United States between demographic and socioeconomic groups. They found that the use of dermatologic care differed widely across various demographic and socioeconomic lines, and indicated the need for further characterization of potential dermatologic health-care differences as well as the improvement in the utilization of outpatient dermatologic care among disadvantaged populations.

Methods

• Researchers retrospectively analyzed nationally representative data from the 2007 to 2015 Medical Expenditure Panel Survey (MEPS) offered by the Agency for Healthcare Research and Quality.
• Using multivariable logistic regression analyses of outpatient and office-based dermatologist visit rates—accounting for sex, age, race/ethnicity, educational level, income, insurance status, region, self-reported condition, and self-reported health status—they examined health-care use outcomes for dermatologic conditions (skin cancers, infections, dermatologic inflammatory conditions/ulcers, and other skin disorders).
• Participants included 183,054 MEPS respondents who visited a dermatologist from 2007 to 2015.
• They assessed if the patient received outpatient care for any dermatologic condition (by payment; primary outcome measure), and determined annual health-care use by individuals with dermatologic conditions (including per capita expenditure for the visit; secondary outcomes).

Results

• A dermatologic condition was self-reported by 10.7% MEPS respondents (mean [SD] age, 34 [23] years; 52.1% female); 9,645 patients had a total of 11,761 outpatient visits to dermatologists.
• The investigators observed that Hispanic (adjusted odds ratio [aOR], 0.55; 95% CI, 0.49-0.61) and black (aOR, 0.42; 95% CI, 0.38-0.46) patients were less likely to receive outpatient care for a dermatologic condition compared with non-Hispanic white patients.
• Also, chances of receiving outpatient dermatologic care were less likely among male vs female patients (aOR, 0.66; 95% CI, 0.62-0.70) and among Midwestern vs Northeastern patients (aOR, 0.80; 95% CI, 0.70-0.91).
• Compared with privately insured patients, patients with Medicaid or Medicare coverage (aOR, 0.75; 95% CI, 0.68-0.83) and uninsured patients (aOR, 0.39; 95% CI, 0.33-0.47) less likeliness to receive outpatient dermatologic care.
• Increased odds of receiving outpatient care for the dermatologic condition were noted in relation to increasing educational level and income.