Comparison of Dermatologist Density Between Urban and Rural Counties in the United States

Abstract

<p class="first" id="d4991205e252">This study analyzes county-level data from nationwide US data to compare dermatologist density between urban and rural areas. </p><div class="section"> <a class="named-anchor" id="ab-doi180042-1"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e258">Questions</h5> <p id="d4991205e260">What are the longitudinal dermatologist density trends, and are there urban and rural disparities? </p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-2"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e263">Findings</h5> <p id="d4991205e265">In this study county-level data from the Area Health Resources File, from 1995 to 2013, dermatologist density increased the most in rural followed by nonmetropolitan and metropolitan counties; however, the gap between metropolitan and other areas also widened. Dermatologists were heterogeneously distributed and consistently located in well-resourced communities. </p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-3"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e268">Meaning</h5> <p id="d4991205e270">The findings suggest that substantial disparities in the geographic distribution of dermatologists exist and have been increasing with time; correcting workforce disparities is important for patient care. </p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-4"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e274">Importance</h5> <p id="d4991205e276">As the US population continues to increase and age, there is an unmet need for dermatologic care; therefore, it is important to identify and understand the characteristics and patterns of the dermatologist workforce. </p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-5"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e279">Objective</h5> <p id="d4991205e281">To analyze the longitudinal dermatologist density and urban-rural disparities using a standardized classification scheme. </p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-6"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e284">Design, Setting, and Participants</h5> <p id="d4991205e286">This study analyzed county-level data for 1995 to 2013 from the Area Health Resources File to evaluate the longitudinal trends and demographic and environmental factors associated with the geographic distribution of dermatologists. </p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-7"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e289">Main Outcomes and Measures</h5> <p id="d4991205e291">Active US dermatologist and physician density.</p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-8"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e294">Results</h5> <p id="d4991205e296">In this study of nationwide data on dermatologists, dermatologist density increased by 21% from 3.02 per 100 000 people to 3.65 per 100 000 people from 1995 to 2013; the gap between the density of dermatologists in urban and other areas increased from 2.63 to 3.06 in nonmetropolitan areas and from 3.41 to 4.03 in rural areas. The ratio of dermatologists older than 55 years to younger than 55 years increased 75% in nonmetropolitan and rural areas (from 0.32 to 0.56) and 170% in metropolitan areas (from 0.34 to 0.93). Dermatologists tended to be located in well-resourced, urban communities. </p> </div><div class="section"> <a class="named-anchor" id="ab-doi180042-9"> <!-- named anchor --> </a> <h5 class="section-title" id="d4991205e299">Conclusions and Relevance</h5> <p id="d4991205e301">Our findings suggest that substantial disparities in the geographic distribution of dermatologists exist and have been increasing with time. Correcting the workforce disparity is important for patient care. </p> </div>