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Reducing Disparities in Access to Dermatology Services: A Review of One Academic Institution’s Comprehensive Outreach Efforts
ABSTRACT
Background:
Maldistribution of providers, variable insurance coverage, and underrepresentation within dermatology all affect patient access to dermatology services. Few studies have evaluated institutional models for addressing these pervasive gaps.
Objective:
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) Dermatology’s outreach clinics compared with general dermatology ambulatory (GDA) clinics in Salt Lake City over three years. Descriptive statistics were reported for patient demographics, insurance, and diagnosis. Statistical methods assessed differences between clinic types. Outreach clinics were categorized by delivery method: rural “fly-in” clinics, live video teledermatology (rural and incarcerated), free clinics in urban areas, and asynchronous eConsults (store-and-forward teledermatology).
Results:
Outreach clinics served 2,283 distinct patients (3,471 encounters). The general dermatology clinics at the University of Utah yielded 207,493 patients (1,141,280 encounters). Outreach clinics overall served a more diverse, younger, and Medicaid-insured patient population than general ambulatory clinics, with a higher prevalence of inflammatory/autoimmune conditions. eConsult and free clinic encounters more commonly served patients under 65 years of age, and eConsult encounters, specifically, served a more racially/ethnically diverse patient population as compared to UUH GDA clinic encounters.
Conclusions:
This study confirms that UUH Dermatology’s efforts to enhance healthcare access are effectively reaching targeted underserved patient populations. Clinical Trial: N/A
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