title: The distribution of epidermolysis bullosa in Australia with a focus on rural and remote areas.
abstract: OBJECTIVE
  Patients with epidermolysis bullosa (EB) require specialised medical care. In Australia this expertise is located in the major cities, with patients living in rural and remote areas having reduced access to these services. We aim to analyse the geographical distribution of patients with EB in Australia to determine the relevance of this potential geographical disadvantage for this population.
  
  
  METHODS
  Using postal codes obtained from the Australian National Diagnostic Laboratory Database for EB and the Australasian EB Registry, living patients with EB in Australia were categorised using the Australian standard geographical classification, remoteness areas. An analysis of EB subtype, including severity was also performed.
  
  
  RESULTS
  A total of 318 patients were categorised, of whom 221 lived in major cities, 65 in inner regional areas, 26 in outer regional areas, four in remote and two in very remote areas. Half the patients living in remote and very remote areas had severe forms of EB.
  
  
  CONCLUSIONS
  A significant proportion of patients with EB live outside the major cities in Australia. Half of the patients living in remote and very remote areas had severe forms of EB. Targeted strategies to improve access to EB-specific medical care may be needed for patients living in rural and remote areas.
authors: Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors: Adam G
authors: AG
authors: Harris
authors: Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.|The Poche Centre for Indigenous Health, Sydney, New South Wales, Australia.|Kaiser Permanente, Medical Group, San Rafael, California, USA.
authors: Nancy R
authors: NR
authors: Todes-Taylor
authors: Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.|Melbourne, Victoria, Australia.
authors: Nenad
authors: N
authors: Petrović
authors: Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors: Dedee F
authors: DF
authors: Murrell
mesh_terms: D001315:Australia / Q000453:epidemiology; D004820:Epidermolysis Bullosa / Q000453:epidemiology* / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D012424:Rural Population / Q000706:statistics & numerical data*
keywords: epidemiology; epidermolysis bullosa; healthcare delivery; rural