title: Use of the emergency department for dermatologic care in the United States by ethnic group.
abstract: OBJECTIVE
  The emergency department (ED) is not the ideal setting for dermatologic care, but may be widely used, especially among disadvantaged ethnic minorities. This study was performed to characterize the role of the ED in providing dermatologic care for each racial and ethnic group in the United States.
  
  
  METHODS
  We analyzed visits from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey from 1993 to 2010. Settings (office-based, outpatient department or ED), diagnoses and race/ethnicity were assessed to compare usage of the ED across groups.
  
  
  RESULTS
  Usage of the ED for dermatologic conditions increased over time (p < 0.0001). EDs were more often used for dermatologic care of black (18.3%) and Hispanic (10.5%) patients than for white patients (5.9%) and were used most in rural or small metropolitan areas.
  
  
  CONCLUSIONS
  Providing better insurance, more dermatologists in rural areas and better dermatologic training for family physicians may help improve care for underserved populations and reduce inappropriate use of the ED.
authors.affiliation: Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine , Winston-Salem, NC , USA.
authors.forename: Manal
authors.initials: M
authors.lastname: Abokwidir
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
authors.forename: Rita O
authors.initials: RO
authors.lastname: Pichardo-Geisinger
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D012871:Skin Diseases / Q000208:ethnology / Q000628:therapy*; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: Health disparities; quality of care; rural; uninsured patients