Benlagha Imene, Nguyen Bichchau Michelle
Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts.
Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts.
JAAD Int. 2021 Apr 22;3:92-101. doi: 10.1016/j.jdin.2021.03.005. eCollection 2021 Jun.
Dermatology practice has recently seen multiple changes. A better understanding of trends pertaining to dermatology practice setups is necessary.
To analyze the recent changes in dermatology practice in terms of geography, practice size, and gender distribution as well as to analyze the availability of dermatologists based on zip codes' income levels.
This was a cross-sectional study. We extracted data on the sex and billing addresses of dermatologists from Medicare provider utilization and payment data for 2012 and 2017. We used 2017 tax returns data to calculate the poverty level for each zip code.
Between 2012 and 2017, the number of solo practitioners decreased, while that of dermatologists working in large groups increased. The southern region experienced the largest changes. The male-to-female ratio decreased. Dermatology practices mainly comprised mixed genders, with a higher proportion of all-male groups versus that of all-female groups, but this difference decreased over time. In the northeastern and western regions, more than one third of dermatologists were located in the wealthiest zip codes.
The Medicare data may not be exhaustively representative of the dermatology workforce, and the zip codes of 489 dermatologists' billing addresses were missing in the tax return dataset.
These findings provide an understanding of the recent changes pertaining to dermatology practice setups and of the substantial health care disparities based on geographic distribution.
皮肤科实践最近发生了多项变化。有必要更好地了解与皮肤科实践设置相关的趋势。
从地理、实践规模和性别分布方面分析皮肤科实践的近期变化，并根据邮政编码的收入水平分析皮肤科医生的可及性。
这是一项横断面研究。我们从2012年和2017年医疗保险提供者利用和支付数据中提取了皮肤科医生的性别和计费地址数据。我们使用2017年纳税申报数据来计算每个邮政编码区域的贫困水平。
2012年至2017年期间，个体执业者数量减少，而在大型团体中工作的皮肤科医生数量增加。南部地区变化最大。男女比例下降。皮肤科实践主要由混合性别组成，男性全男性团体的比例高于女性全女性团体，但这种差异随着时间的推移而减小。在东北部和西部地区，超过三分之一的皮肤科医生位于最富裕的邮政编码区域。
医疗保险数据可能无法完全代表皮肤科劳动力，纳税申报数据集中缺少489名皮肤科医生计费地址的邮政编码。
这些发现有助于了解皮肤科实践设置的近期变化以及基于地理分布的巨大医疗保健差异。
