Race; ethnicity; health disparities; office visits; dermatology; health services accessibility; Medicare; Medicaid; predictive value of tests.


Public Health | Translational Medical Research


Objective:To determine whether differences in race and ethnicity affect the usage of dermatological services.

Methods: Data from the National Ambulatory Medical Care Survey were used to study trends in ethnic/race rates of outpatient dermatology office visits among publicly and privately insured patients from 2005-2010. In multivariable models, we explored the magnitude of ethnic/race differences in dermatology visit attendance for patients with public vs. private insurance.

Results: From 2005-2010, dermatology visit utilization increased among insured Hispanics, but not among insured non-Hispanic Blacks or whites. Visits were less frequent by those with public insurance compared to private insurance. Privately and publicly insured visits were less common for non-Hispanic Blacks and Hispanics compared to whites after adjustment for patient demographics and primary visit diagnosis. Racial and ethnic differences in visit utilization rates were most apparent among non-referred visits. However, primary diagnoses for non-referred visits were similar across races and ethnicities, which suggests that differences in utilization may result from factors unrelated to clinical indications for care.

Conclusion: Ethnic/race differences in the use of dermatological services in the United States may result from patient preferences for dermatologic care or health system related factors (e.g., insurance coverage regulations).