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ObjectiveTo determine the impact of race concordance on patient perception of quality of dermatologic care.Study designCross-sectional study.SettingAcademic outpatient practices in the Departments of Dermatology of Eastern Virginia Medical School and the Johns Hopkins University School of Medicine.ParticipantsThe study cohort comprised 124 participants including 6 providers and 118 established patients.Main Outcome MeasuresWe hypothesized, a priori, that patients in race-discordant dyads would report lower ratings of participatory decision-making (PDM), satisfaction, trust in the provider, and similarities with providers.ResultsPatients in race-discordant dyads reported less positive ratings on 4 out of 8 participatory decision-making questionnaire items (p values < 0.05), and were significantly more likely to perceive differences with providers in race and culture (p values < 0.05). These differences persisted to varying degrees after controlling for key confounders such as education and income level. Participants in race-concordant and race-discordant dyads did not differ in their perceptions of satisfaction or trust.ConclusionsPatient perception of participation in the decision-making process and of shared similarities with their providers is attributable in varying degrees to race concordance. Continued strengthening of cultural competency skills during medical and dermatology residency training as well as increased diversification of the dermatologic workforce could attenuate the adverse influences of race discordance and other socioeconomic factors on patient-provider communication.

To review the literature on atopic dermatitis (AD) clinical trials published in the United States between 2000 and 2009 to examine the representation of racial and ethnic minorities in those trials and determine the extent to which investigators reported on demographic variables and performed a subanalysis. A PubMed search was performed including all clinical trials for management of AD published between 2000 and 2009. Three reviewers analyzed articles matching the search criteria. Data recorded included incorporation of demographic data at baseline and in the analysis and result interpretations. Of 645 PubMed search results, only 78 articles originated in the United States and fit the search criteria; 59.5% of these included reports of race or ethnicity. Of the studies reporting race or ethnicity, the subject population mainly included 62.1% white, 18.0% black, 6.9% Asian, and 2.0% Hispanic. Despite increasing awareness in the United States of the importance of reporting demographic data in clinical trials, there has been no significant improvement in reporting in AD clinical trials over the past 10 years. When reporting occurs, the categorization of ethnicities, methods of reporting data, and incorporation of the data into the results are lacking or flawed. In addition, aside from blacks, U.S. minorities appear to be underrepresented in AD clinical trials., (© 2012 Wiley Periodicals, Inc.)

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]