Trends in Patch Testing by Health Care Providers Among US Medicare Beneficiaries

Abstract

Background: Although patch testing has historically been done by dermatologists, allergists are also patch testing. Little is known about the current utilization of patch testing by medical specialists.Objective: The aim was to determine trends in utilization of patch testing in Medicare beneficiaries by various clinicians and demographics.Methods: Data from the 2012-2017 Medicare Public Use File were analyzed, including 82,241 total unique clinicians of whom 312 filed a patch testing claim.Results: Dermatologists had a steady share of patch tests (annual clinicians; annual patches) from 2012 (158; 258,735) to 2017 (199; 351,994), an increase of 25.9% and 36.0%, respectively. Allergists, however, had a marked increase in utilization of patch tests from 2012 (84; 62,498) to 2017 (187; 182,480), an increase of 122.6% and 192.0%, respectively. In multivariable logistic regression models, male dermatologists and allergists had increased odds of patch testing (P < 0.001 for both), as did clinicians in the Northeast and Southern United States (P ≤ 0.003 for both).Limitations: Data are only available for Medicare Part B patients; changes in utilization may be different for individuals, private insurance, or Medicare Advantage Plans.Conclusions: Relative to dermatologists, patch testing is increasing among allergists. Addressing barriers to patch testing may increase rates of patch testing by dermatologists.