Variation in dermatologist visits by sociodemographic characteristics

Mulcahy, Andrew W.; Mehrotra, Ateev; Edison, Karen E.; Uscher‐Pines, Lori

doi:10.1016/j.jaad.2016.10.045

Cited by 27 publications

(14 citation statements)

References 10 publications

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“…Furthermore, Medicaid patients were three times as likely to be seen by a provider type other than a dermatologist, allergist, or pediatrician, compared with Commercial patients (68.9% vs. 22.9%). These results support, but exceed, those of a retrospective study using data from the 2008 to 2012 Medical Expenditure Panel Survey, documenting a <50% likelihood of receiving a diagnosis for a skin-related disease from a dermatologist, for Medicaidinsured compared with privately insured individuals [43]. The large proportion of Medicaid patients seen by other provider types may reflect evaluation/management of Medicaid patients by a non-specialist provider in an ED or urgent care setting.…”

Section: Discussionsupporting

confidence: 53%

Effects of variations in access to care for children with atopic dermatitis

et al. 2020

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Background An estimated 50% of children in the US are Medicaid-insured. Some of these patients have poor health literacy and limited access to medications and specialty care. These factors affect treatment utilization for pediatric patients with atopic dermatitis (AD), the most common inflammatory skin disease in children. This study assesses and compares treatment patterns and healthcare resource utilization (HCRU) between large cohorts of Medicaid and commercially insured children with AD. Methods Pediatric patients with AD were identified from 2 large US healthcare claims databases (2011–2016). Included patients had continuous health plan eligibility for ≥6 months before and ≥12 months after the first AD diagnosis (index date). Patients with an autoimmune disease diagnosis within 6 months of the index date were excluded. Treatment patterns and all-cause and AD-related HCRU during the observation period were compared between commercially and Medicaid-insured children. Results A minority of children were evaluated by a dermatology or allergy/immunology specialist. Several significant differences were observed between commercially and Medicaid-insured children with AD. Disparities detected for Medicaid-insured children included: comparatively fewer received specialist care, emergency department and urgent care center utilization was higher, a greater proportion had asthma and non-atopic morbidities, high- potency topical corticosteroids and calcineurin inhibitors were less often prescribed, and prescriptions for antihistamines were more than three times higher, despite similar rates of comorbid asthma and allergies among antihistamine users. Treatment patterns also varied substantially across physician specialties. Conclusions Results suggest barriers in accessing specialty care for all children with AD and significant differences in management between commercially and Medicaid-insured children. These disparities in treatment and access to specialty care may contribute to poor AD control, especially in Medicaid-insured patients.

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Section: Discussionsupporting

confidence: 53%

Effects of variations in access to care for children with atopic dermatitis

et al. 2020

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“…Medicaid enrollees encounter longer wait times to see a dermatologist and therefore are less likely to have visited an outpatient dermatologist in a given year than individuals with private insurance. 9,10 To reduce costly inpatient admissions for skin disease, policy makers should consider increasing Medicaid reimbursement rates to outpatient dermatologists, which might encourage more clinicians to accept this form of insurance and thereby expand access to preventative skin care. The number of uninsured patients in the United States will rise if the Affordable Care Act is repealed.…”

Section: Mortalitymentioning

confidence: 99%

Inpatient burden of pediatric dermatology in the United States

Arnold

Yoon

Kirkorian

2018

Pediatric Dermatology

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“…10 These patients tend to visit their physician more frequently and to require more intensive care coordination from the practice between visits. Given differences in healthcare utilization between men and women, [39][40][41] it was interesting to note that gender was not associated with receiving CCM services in this analysis. Race/ethnicity, however, was associated with receipt of CCM services.…”

Section: Discussionmentioning

confidence: 99%

Use of Chronic Care Management Codes for Medicare Beneficiaries: a Missed Opportunity?

et al. 2018

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The CCM code is likely underutilized in New England; the program may therefore not be achieving its intended goal of encouraging consistent, team-based chronic care management for Medicare's most complex beneficiaries. Or practices may be foregoing reimbursement for care coordination that they are already providing. Recently implemented revisions may improve uptake of CCM services; it will be important to compare our results with future utilization.

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Variation in dermatologist visits by sociodemographic characteristics

Cited by 27 publications

References 10 publications

Effects of variations in access to care for children with atopic dermatitis

Effects of variations in access to care for children with atopic dermatitis

Inpatient burden of pediatric dermatology in the United States

Use of Chronic Care Management Codes for Medicare Beneficiaries: a Missed Opportunity?

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