Patients' Reasons for Seeking Dermatological Care and Perception of Their Access to Dermatological Care: Rural and Urban Variations

Objective:

Describe respondents' reasons for seeking care for dermatological problems and perception of access to specialized dermatological care.

Methods:

Patients completed a pre-tested survey soliciting perceptions about seeking dermatological care and access to dermatological care in the waiting rooms of six dermatology clinics throughout the central Midwest between June - August 2007. A convenience sample of 365 patients had a response rate of 100%.

Results:

Descriptive statistics summarize respondents' demographics. The Chi-square statistic assessed demographic differences comparing rural respondents (a town of less than 50,000) versus urban respondents (a town of 50,000 or more). Since data values were not normally distributed, the nonparametric test Mann - Whitney U tests were used to compare rural versus urban ranking and time integer values.

Mainly, changes in skin appearance or the presence of an abnormality compelled patients to make an appointment with either a dermatologist or primary care physician. Urban respondents were more likely (p <.05) to seek treatment for odd or unusual skin appearances than rural respondents. The majority noted that they typically go directly to a dermatologist for treatment of skin problems and perceive dermatologists as better trained to treat skin conditions. Overall wait time for a dermatologist appointment was three times that of a primary care physician (p <.05) and the average travel time to see a dermatologist was significantly longer (p <.05) for those who reside in rural areas.

Conclusions: This study highlighted respondents' positive perceptions of dermatologists, but noted problems with access to dermatological care in rural areas.