A barrier to care: Distance traveled affects adherence to treatment and follow‐up plans for patients with infantile hemangioma

Abstract

A chart review was performed of all patients diagnosed with infantile hemangioma in the pediatric dermatology clinic to determine whether distance traveled by the patient affected adherence to follow-up and treatment plans. An increase in distance was associated with an increase in likelihood of nonadherence to treatment or follow-up plans. Compared to patients who lived within 10 miles of a pediatric dermatologist, families who lived farther away were less likely to adhere to treatment plans. Families who traveled over 20 miles to clinic were 7.38 times more likely to be nonadherent to the treatment plan than those who traveled 0-10 miles.

The geographic distribution of the US pediatric dermatologist workforce: A national cross‐sectional study

“…Given that poor access to dermatologists can lead to delays in care and worse dermatologic disease outcomes, it is critical to improve patients' access to pediatric dermatologists 7,8,25 . Therefore, while the SPD continues to develop and implement strategies to increase the pediatric dermatology workforce, efforts should also be made to improve the distribution of the current workforce.…”

“…Given that poor access to dermatologists can lead to delays in care and worse dermatologic disease outcomes, it is critical to improve patients' access to pediatric dermatologists. 7,8,25 Jennifer T. Huang https://orcid.org/0000-0001-6191-7486…”

“…Studies have cited that longer travel distances and less specialist access decrease patients' adherence to treatment plans, increase non-attendance rates for follow-up visits, and worsen patients' clinical outcomes. [7][8][9][10] Furthermore, children with unmet specialist-care needs tend to also be the most vulnerable members of society:…”

“…Although the pediatric dermatologist undersupply is well‐documented, 1 little is known about the geographic distribution of pediatric dermatologists across the US relative to the population of children and pediatric generalists, both of which may serve as proxies for areas with the greatest need for pediatric dermatologists. Studies have cited that longer travel distances and less specialist access decrease patients' adherence to treatment plans, increase non‐attendance rates for follow‐up visits, and worsen patients' clinical outcomes 7‐10 . Furthermore, children with unmet specialist‐care needs tend to also be the most vulnerable members of society: Compared to nonpoor children, children who live below the federal poverty level or are uninsured have 2.5 times and 4.3 times higher likelihood of reporting unmet need for pediatric subspecialty care, respectively 11 .…”

Demographic and medical school characteristics associated with urban versus rural dermatology practice: A national cross-sectional study

“…Owing to dermatologist shortages in rural areas, studies have shown that rural residents travel longer distances to see specialists, experience longer wait times, and suffer higher mortality rates from melanoma and Merkel cell carcinoma compared with urban residents [1][2][3][4]. In turn, longer travel distances to dermatologists lead to decreased treatment adherence and higher non-attendance rates [5]. Recent data have highlighted that younger dermatologists are increasingly practicing in urban settings, suggesting that the urban-rural workforce gap will continue to widen if strategies to recruit rural dermatologists are not implemented [1].…”