Stern R S, Nelson C
Department of Dermatology, Beth Israel Hospital, Harvard Medical School, Boston, MA 02215.
J Am Acad Dermatol. 1993 Nov;29(5 Pt 1):773-7. doi: 10.1016/0190-9622(93)70243-m.
The number of physicians who provide ambulatory care for patients with skin diseases is rapidly increasing. Current and proposed changes in health care financing may limit direct access to dermatologists. We provide recent data on volume of visits for cutaneous diagnoses, including the types of medical practitioners who provided these ambulatory services, and compare these data with earlier surveys that span 15 years. In 1989, dermatologists saw 41% of the 51.6 million persons with cutaneous diagnoses. The number of visits per dermatologist declined significantly from 1974 to 1989 (p < 0.05). Visits to dermatologists were significantly more likely to be reimbursed by Blue Cross/Blue Shield or self-pay than visits to other physicians for skin problems. From 1974 to 1989, the demand for dermatologic services from dermatologists has not increased as rapidly as the supply of dermatologists. Our data also suggest that restrictions on direct access to dermatologists or changes in reimbursement may substantially decrease the demand for services provided by dermatologists.
为皮肤病患者提供门诊护理的医生数量正在迅速增加。当前和提议的医疗保健融资变化可能会限制直接找皮肤科医生看病的机会。我们提供了近期皮肤诊断就诊量的数据，包括提供这些门诊服务的医生类型，并将这些数据与过去15年的早期调查数据进行比较。1989年，皮肤科医生诊治了5160万皮肤诊断患者中的41%。从1974年到1989年，每位皮肤科医生的就诊量显著下降（p<0.05）。与因皮肤问题找其他医生就诊相比，找皮肤科医生就诊更有可能由蓝十字/蓝盾保险或自费支付费用。从1974年到1989年，对皮肤科医生服务的需求增长速度不如皮肤科医生的供给增长速度快。我们的数据还表明，对直接找皮肤科医生看病的限制或报销政策的变化可能会大幅降低对皮肤科医生提供服务的需求。
