The Effects of Outreach Initiatives on Equitable Access to Dermatology Services: Single-Center Retrospective Analysis.

BACKGROUND

Maldistribution of providers, differences in insurance coverage and acceptance, and underrepresentation of underserved patient populations in dermatology all affect patient access to dermatology services. Few studies have evaluated institutional models to address these pervasive gaps.

OBJECTIVE

The aim of this study was to evaluate one academic institution's efforts to comprehensively expand access to dermatology services.

METHODS

A retrospective analysis was performed using data from the University of Utah Health (UUH) Department of Dermatology's outreach initiatives compared with general dermatology ambulatory clinics on UUH's main campus in Salt Lake City, Utah, over 3 years. Descriptive statistics were reported for patient demographics, insurance coverage, and diagnoses at the encounter level. Statistical methods assessed differences between clinic types. Outreach initiatives were categorized by delivery method: rural in-person clinics, urban in-person charity care clinics, live video teledermatology in rural and incarcerated settings, and asynchronous eConsults (store-and-forward teledermatology).

RESULTS

Outreach initiatives served 2283 distinct patients in 3471 encounters. The general dermatology clinics at UUH served 207,493 patients in 1,141,280 encounters. Overall, UUH outreach initiatives served a more diverse, younger, and Medicaid-insured patient population with a higher prevalence of inflammatory/autoimmune conditions than its general ambulatory dermatology clinics. eConsult and charity care clinics more commonly served patients younger than 65 years of age, and eConsults in particular served a more racially and ethnically diverse patient population compared with the general dermatology clinics.

CONCLUSIONS

This study confirms that UUH Dermatology's efforts to enhance health care access effectively reach targeted underserved patient populations that are underrepresented at UUH's general dermatology clinics.