Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Dermatol Online J. 2023 Feb 15;29(1). doi: 10.5070/D329160208.
Geographic maldistribution of dermatologists contributes to disparities in access to dermatologic care. We aimed to investigate the geographic distribution of, and differences in wait times for medical dermatology services in Los Angeles County (LAC). We placed phone calls to 251 dermatology practices in LAC to ask for a new patient appointment for a changing mole. We found West LAC (Service Planning Area [SPA] 5) had the highest number of dermatologists and South LAC (SPA 6) had the lowest (26.1 versus 0 per 100,000 residents, P=0.01). Service Planning Area 6 has a higher non-White, uninsured, and impoverished population than SPA 5. Dermatology appointment wait times and Medicaid acceptance varied between SPAs but was not statistically significant (P=0.37 and P=0.20, respectively). Medicaid-accepting practices had a significantly longer mean wait time for an appointment than practices that did not accept Medicaid (26.1 versus 15.1 days, P=0.003). Regions with predominantly non-White, Spanish-speaking, and medically underinsured residents were found to be disproportionately lacking in dermatologists across LAC, which may contribute to impaired access to dermatology services in LAC.
皮肤科医生的地理分布不均导致皮肤科医疗服务的可及性存在差异。我们旨在研究洛杉矶县（LAC）的皮肤科医疗服务的地理分布情况和等待时间的差异。我们致电 LAC 的 251 家皮肤科诊所，要求为一位变化的痣患者预约新病人。我们发现，西部 LAC（服务规划区[SPA] 5）的皮肤科医生数量最多，而南部 LAC（SPA 6）的数量最少（每 10 万人中有 26.1 名与 0 名，P=0.01）。SPA 6 的非白人、未参保和贫困人口比例高于 SPA 5。皮肤科预约等待时间和医疗补助接受情况在 SPA 之间存在差异，但无统计学意义（P=0.37 和 P=0.20）。接受医疗补助的诊所的预约等待时间中位数明显长于不接受医疗补助的诊所（26.1 天与 15.1 天，P=0.003）。在 LAC，发现以非白人、讲西班牙语和医疗保障不足的居民为主的地区普遍缺乏皮肤科医生，这可能导致 LAC 的皮肤科医疗服务获取受限。
