Use of the emergency department for dermatologic care in the United States by ethnic group

Abstract

Objectives: The emergency department (ED) is not the ideal setting for dermatologic care, but may be widely used, especially among disadvantaged ethnic minorities. This study was performed to characterize the role of the ED in providing dermatologic care for each racial and ethnic group in the United States. Methods: We analyzed visits from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey from 1993 to 2010. Settings (office-based, outpatient department or ED), diagnoses and race/ethnicity were assessed to compare usage of the ED across groups. Results: Usage of the ED for dermatologic conditions increased over time (p < 0.0001). EDs were more often used for dermatologic care of black (18.3%) and Hispanic (10.5%) patients than for white patients (5.9%) and were used most in rural or small metropolitan areas. Conclusions: Providing better insurance, more dermatologists in rural areas and better dermatologic training for family physicians may help improve care for underserved populations and reduce inappropriate use of the ED.

• Health disparities
• quality of care
• rural
• uninsured patients

Declaration of interest

The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, L.P. Dr. Fleischer has received grants from Abbott, Anacor, Eli Lilly, Galderma, and Regeneron, has served on the advisory board for Celgene, has been a consultant for Kikaku America International, and is employed by Merz Pharmaceuticals. Dr. Abokwidir, Dr. Pichardo-Geisinger and Mr. Davis have no conflicts to disclose.