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西班牙裔患者与非西班牙裔白人患者在前往皮肤科诊所、初级保健诊所和急诊科方面的差异。

Differences in accessing dermatology offices, primary care offices, and emergency departments between Hispanics and Non-Hispanic White Patients.

作者信息

Zagona-Prizio Caterina, Khan Sabrina, Yee Danielle K, Khan Samiya, Maynard Nicole, Reddy Rasika, Mehta Manan D, Wu Kevin, Armstrong April W

机构信息

Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

出版信息

Dermatol Online J. 2023 Feb 15;29(1). doi: 10.5070/D329160207.

Abstract

How Hispanic patients access dermatologic care for skin diseases is unknown. This study aims to determine if differences exist in accessing the emergency department (ED), primary care, and outpatient dermatologic offices for skin diseases between Hispanic and non-Hispanic White patients. This cross-sectional study used nationally representative data from the Medical Panel Expenditure Survey (MEPS) from 2016-2019. A total of 109,337,668 (weighted) patients with any skin disease diagnosed at an ED, primary care, or dermatology visit were identified. Hispanics comprised 13.0% and non-Hispanic Whites comprised 68.8% of this subpopulation. Overall, 94.1% of Hispanic patients attended a primary care visit for their skin complaint, 5.8% saw a dermatologist, and 0.1% attended an ED visit. Compared to non-Hispanic Whites, Hispanics were more likely to attend a primary care visit (aOR 1.865; 95%CI, 1.640-2.122) and less likely to attend an outpatient dermatology visit (aOR 0.536; 95%CI, 0.471-0.610), after adjusting for insurance status, education, income, sex, age, and comorbidities. Our study suggests that, compared to non-Hispanic Whites, Hispanic patients access primary care more frequently and outpatient dermatologic offices less frequently for their skin conditions. Language barriers, less familiarity with the healthcare system, and lack of adequate health insurance may play roles in this observation.

摘要

西班牙裔患者如何获得皮肤病的皮肤科护理尚不清楚。本研究旨在确定西班牙裔和非西班牙裔白人患者在因皮肤病前往急诊科(ED)、初级保健机构和门诊皮肤科就诊方面是否存在差异。这项横断面研究使用了2016 - 2019年医疗支出面板调查(MEPS)的全国代表性数据。总共确定了109337668名(加权)在急诊科、初级保健机构或皮肤科就诊时被诊断患有任何皮肤病的患者。该亚组人群中西班牙裔占13.0%,非西班牙裔白人占68.8%。总体而言,94.1%的西班牙裔患者因皮肤问题前往初级保健机构就诊,5.8%看皮肤科医生,0.1%前往急诊科就诊。在调整保险状况、教育程度、收入、性别、年龄和合并症后,与非西班牙裔白人相比,西班牙裔患者更有可能前往初级保健机构就诊(调整后比值比[aOR]为1.865;95%置信区间[CI],1.640 - 2.122),而前往门诊皮肤科就诊的可能性较小(aOR为0.536;95%CI,0.471 - 0.610)。我们的研究表明,与非西班牙裔白人相比,西班牙裔患者因皮肤状况更频繁地前往初级保健机构就诊,而较少前往门诊皮肤科就诊。语言障碍、对医疗系统不太熟悉以及缺乏足够的医疗保险可能在这一现象中起作用。

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