University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
Yankton Medical Clinic, Yankton, South Dakota.
S D Med. 2022 Nov;75(11):504-508.
Nearly 40 percent of dermatologists in the U.S. practice in the 100 most population dense areas, with less than 10 percent practicing in rural areas. Rurality, delayed detection time, and increased travel distance have been associated with worse malignancy outcomes. Without their local rural dermatologist, we hypothesized patients would face significantly increased travel distance and be less likely to receive dermatological care.
A survey was created to assess travel distance, likelihood to travel further for care, and use of primary care providers for dermatologic care. Eligible participants of the IRB approved study were patients of the only dermatology clinic in Yankton, South Dakota. Yankton is a town in southeastern South Dakota with a population of 14,687.
Overall, 100 surveys were completed. Most patients (53.5 percent) did not know where they would receive dermatologic care if the dermatology clinic was not available. The average patient would travel 42.6 miles further to the closest non-outreach dermatology clinics. Over 25 percent of patients were unlikely or not willing to travel further for care. As patient's age increased, so did their likelihood to travel further.
The data supports the hypothesis that without their local rural dermatologist, patients would face significantly increased travel distance and be less likely to receive dermatological care. Given the barriers to care in rural areas, it is imperative to proactively confront these challenges. Further studies are needed to assess for confounding factors in this dynamic and develop innovative solutions.
美国近 40%的皮肤科医生在人口最密集的 100 个地区行医，不到 10%的医生在农村地区行医。农村地区、检测时间延迟和旅行距离增加与恶性肿瘤结局恶化有关。如果没有当地的农村皮肤科医生，我们假设患者将面临显著增加的旅行距离，并且不太可能获得皮肤科护理。
创建了一项调查，以评估旅行距离、是否更有可能为了获得治疗而长途跋涉，以及是否使用初级保健提供者进行皮肤科护理。这项经机构审查委员会批准的研究的合格参与者是南达科他州扬克顿唯一皮肤科诊所的患者。扬克顿是南达科他州东南部的一个城镇，人口为 14687 人。
总体而言，完成了 100 份调查。大多数患者（53.5%）不知道如果皮肤科诊所不可用，他们将在哪里获得皮肤科护理。平均每位患者将多行驶 42.6 英里前往最近的非外展皮肤科诊所。超过 25%的患者不太可能或不愿意长途跋涉去接受治疗。随着患者年龄的增长，他们长途跋涉的可能性也会增加。
数据支持这样一种假设，即如果没有当地的农村皮肤科医生，患者将面临显著增加的旅行距离，并且不太可能获得皮肤科护理。鉴于农村地区存在护理障碍，积极应对这些挑战至关重要。需要进一步研究以评估这种动态中的混杂因素，并开发创新解决方案。
