Skin disease in the uninsured: Diagnoses, management decisions, and referral outcomes of an urban free clinic

Brooke E. Rosenbaum, Derek Freitas, Sarah C. Nosal, Ahou Meydani

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

An understanding of the burden of skin disease in the uninsured population is needed to address the unique barriers they face to access dermatologic care. We conducted a retrospective chart review of patients seen for skin conditions over three years at the New York City (NYC) Free Clinic, a weekly primary care clinic operated by the NYU School of Medicine and the Institute for Family Health. Main outcomes of this study were descriptive analyses of demographic characteristics, diagnoses, management strategies, and referral outcomes, as well as key factors influencing referral to a dermatologist and referral attendance. Diagnosis was a significant predictor of referral (p<.000). The referral attendance rate was 52.5%. Patients older than 50 years were more likely to attend their appointments than younger patients (p=.025). Gender, wait time, and travel distance had no significant association with non- attendance. While demand for dermatologic care by uninsured patients in NYC is high, referral non- attendance remains a substantial barrier to care.

Original languageEnglish
Pages (from-to)834-845
Number of pages12
JournalJournal of Health Care for the Poor and Underserved
Volume27
Issue number2
DOIs
StatePublished - May 2016
Externally publishedYes

Keywords

  • Access to health care
  • Dermatology
  • Health services accessibility
  • Managed care programs
  • Medically uninsured
  • Primary care physicians
  • Referrals
  • Skin diseases
  • Underserved populations

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