title: Variation in dermatologist visits by sociodemographic characteristics.
abstract: BACKGROUND
  Access to dermatologists is an ongoing concern for Medicaid enrollees. Understanding current use is a key step toward designing and implementing policies to improve access.
  
  
  OBJECTIVE
  We sought to quantify how often Medicaid enrollees visit dermatologists and receive treatment for skin-related conditions compared with patients with other coverage or without health insurance.
  
  
  METHODS
  We conducted a retrospective cross-sectional analysis of multiyear federal survey data (Medical Expenditure Panel Survey). The sample included Medical Expenditure Panel Survey respondents younger than 65 years from 2008 to 2012.
  
  
  RESULTS
  In unadjusted comparisons, we found that 1.4% of Medicaid enrollees had an ambulatory visit to a dermatologist annually, compared with 1.2% of uninsured individuals and 5.5% of individuals with private coverage. In adjusted models, we found that health insurance source, age, sex, race/ethnicity, and geography are associated with the likelihood of having visits to a dermatologist. Compared with individuals with private coverage, Medicaid enrollees are less likely to receive a diagnosis for a skin condition by any provider and are less than half as likely to have skin-related diagnoses made by dermatologists.
  
  
  CONCLUSIONS
  We have relatively few Medical Expenditure Panel Survey respondents for a subset of specific diagnoses.
  
  
  CONCLUSIONS
  Our findings emphasize the need for efforts to reduce disparities in access to dermatologists.
authors.affiliation: RAND Corporation, Arlington, Virginia. Electronic address: amulcahy@rand.org.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mulcahy
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Ateev
authors.initials: A
authors.lastname: Mehrotra
authors.affiliation: University of Missouri Health System, Columbia, Missouri.
authors.forename: Karen
authors.initials: K
authors.lastname: Edison
authors.affiliation: RAND Corporation, Arlington, Virginia.
authors.forename: Lori
authors.initials: L
authors.lastname: Uscher-Pines
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003880:Dermatology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D012871:Skin Diseases / Q000175:diagnosis* / Q000628:therapy; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Medicaid; Medical Expenditure Panel Survey; dermatology; disparities; health care utilization