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Objective: To determine whether differences in race and ethnicity affect the usage of dermatological services. Methods: Data from the National Ambulatory Medical Care Survey were used to study trends in ethnic/race rates of outpatient dermatology office visits among publicly and privately insured patients from 2005-2010. In multivariable models, we explored the magnitude of ethnic/race differences in dermatology visit attendance for patients with public vs. private insurance. Results: From 2005-2010, dermatology visit utilization increased among insured Hispanics, but not among insured non-Hispanic Blacks or whites. Visits were less frequent by those with public insurance compared to private insurance. Privately and publicly insured visits were less common for non-Hispanic Blacks and Hispanics compared to whites after adjustment for patient demographics and primary visit diagnosis. Racial and ethnic differences in visit utilization rates were most apparent among non-referred visits. However, primary diagnoses for non-referred visits were similar across races and ethnicities, which suggests that differences in utilization may result from factors unrelated to clinical indications for care. Conclusion: Ethnic/race differences in the use of dermatological services in the United States may result from patient preferences for dermatologic care or health system related factors (e.g., insurance coverage regulations). [ABSTRACT FROM AUTHOR]

Mycosis fungoides, the most common form of cutaneous T-cell lymphoma, has a higher incidence and poorer prognosis in African-Americans. The factors that may be contributing to this disparity are presented in the context of a health disparities framework that includes discussion of patient-related factors such as race/ethnicity, socioeconomic status, and biological differences, provider-related factors such as patient-provider communication and the competing demands for providers' time, and health care system-related factors such as access to health care and workforce diversity. The changing demographics of the USA emphasize the need to understand and address health disparities in mycosis fungoides and other dermatologic diseases. The framework presented here can be used to examine disparities in other dermatologic conditions and advance health disparities research in dermatology. [ABSTRACT FROM AUTHOR]