Tran Amity, Leibovitch Emily, Stafford Michelle, Prabhudesai Devashri, Chen John J, Witten Nash
Internal Medicine, University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, USA.
Pediatrics, University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, USA.
Cureus. 2024 Aug 11;16(8):e66650. doi: 10.7759/cureus.66650. eCollection 2024 Aug.
Although there is evidence that Medicaid beneficiaries in the continental United States experience barriers to accessing dermatological care, limited data exists on whether these same barriers exist in Hawai'i. Using a secret shopper study design, a total of 46 dermatology offices were contacted, 41 (89%) of which were accepting new patients. Thirty (73%) offices were located on O'ahu, and the remaining 11 (27%) were distributed among the neighboring islands (Hawai'i Island, Kaua'i, Maui). Overall, the acceptance rate for Medicaid (n=14) was 34%, which was significantly lower (P<.0001) than private insurance (n=39 (95%)) and Medicare (n=38 (93%)). The acceptance rate for patients with Medicaid insurance was lower for O'ahu offices (27%) than for neighboring islands' offices (55%), but the difference was not statistically significant (P=.095). Differences in average wait times were not statistically significant among insurance types or between O'ahu and neighboring islands. Overall, these results suggest that Medicaid recipients compared to those with private insurance or Medicare might experience difficulty in accessing dermatological care in Hawai'i.
尽管有证据表明美国大陆的医疗补助计划受益人在获得皮肤科护理方面存在障碍，但关于夏威夷是否存在同样的障碍的数据有限。采用暗访研究设计，共联系了46家皮肤科诊所，其中41家（89%）接受新患者。30家（73%）诊所在瓦胡岛，其余11家（27%）分布在邻近岛屿（夏威夷岛、考艾岛、毛伊岛）。总体而言，医疗补助计划（n = 14）的接受率为34%，显著低于私人保险（n = 39（95%））和医疗保险（n = 38（93%））（P <.0001）。瓦胡岛诊所的医疗补助保险患者接受率（27%）低于邻近岛屿诊所（55%），但差异无统计学意义（P =.095）。不同保险类型之间或瓦胡岛与邻近岛屿之间的平均等待时间差异无统计学意义。总体而言，这些结果表明，与拥有私人保险或医疗保险的人相比，夏威夷的医疗补助计划受益人在获得皮肤科护理方面可能会遇到困难。
