Disparities in access for melanoma screening by region, specialty, and insurance: A cross-sectional audit studyCapsule Summary

JAAD International

Barbara Grimes, PhD, MS¹  Raj P. Fadadu, MS²  Sailesh Konda, MD³  Maria L. Wei, MD, PhD⁴  Jose Luis Cortez, MD, MS⁵ 

[1] Correspondence to: Jose Luis Cortez, MD, MS, Department of Dermatology, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC07 4240, Albuquerque, NM 94115.;Department of Dermatology, University of California, San Francisco, California;Dermatology Service, San Francisco Veterans Affairs Health Care System, San Francisco, California;Department of Dermatology, University of California, San Francisco, California;Department of Dermatology, University of New Mexico, Albuquerque, New Mexico;

关键词: Bay Area;    California;    Central Valley;    dermatology;    family medicine;    health disparities;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Early detection of melanoma is critical for positive outcomes. However, access for the diagnosis of melanoma remains problematic for segments of the general population. Objective: To compare the rates of dermatology and family medicine practitioner acceptances for a public insurance (Medicaid) versus private insurance (Anthem Blue Cross) and clinic wait times for an appointment for a changing pigmented skin lesion concerning melanoma in rural and urban regions in California. Methods: Cross-sectional audit study between June 2017 and March 2019; scripted phone calls were made to dermatology and family medicine practices (FMPs). Results: Family medicine and dermatology practices in both regions had significantly decreased acceptance of Medicaid. Dermatology practices had 11.3% to 13.0% Medicaid acceptance rates that were less than FMP rates of 28% to 36%. In both regions, FMP wait times were 2.4- to 3.2-fold longer for public versus private insurance; there were little differences in wait times for the 2 insurance types in dermatology practices, in both regions. Limitations: Assessment of only 2 regions in the state of California. Conclusion: Delays at FMPs and insurance types limit access to melanoma screening in California for underserved segments of the general population, which has implications for melanoma outcomes and health policy.

【 授权许可】

Unknown