Abstract
Background: COVID-19 materially delayed patient visits and potential skin cancer biopsies/diagnoses among US dermatology practices. However, given a likely heterogenous impact across the US, this study sought to determine COVID-19’s effect on urban versus rural dermatology practices. Methods: Data were analyzed from the first 1000 responses to 3 pre-validated surveys of 9891 practicing US dermatologists comparing outpatient volumes and scheduling issues for the week of February 17th to the week of March 16th (Survey 1), April 13th (Survey 2) and May 18th, 2020 (Survey 3). First 3 US zip-code digits were compared to US Census Bureau data to determine “Urban/Rural” status. Representativeness with AAD membership was confirmed. Statistical significance was calculated using chi-square with Marascuilo procedure and two-tailed independent t-test/ANOVA with post-hoc Tukey-Kramer testing. Results: In April 2020 urban practices reported more closed practices (21.4% vs 5.8%, p<0.0001) and predicted significantly larger patient volume decreases (-45.2% vs -31.4%, p<0.0001) and practice closures (11.9% vs. 2.5% p<0.0001) in the following 2 weeks. In May 2020, urban areas saw significantly fewer patients/week (90.9 vs 142.4 p<0.0001), larger decrease in patient volume relative to May 2019 (-49.4% vs -35.1%, p<0.0001), and conducted more telemedicine visits (27.0% vs 15.1%, p<0.0001). Significantly more rural practices reported already being at baseline volume (Mean Difference 6.2%, 95% CI 2.7%-9.8%) while urban practices predicted return to baseline volume by August (5.7, 95% CI 2.1%-9.3%) or were unsure (5.6, 95% CI 1.6%-9.7%). Conclusion: The initial COVID-19 pandemic differentially affected urban dermatology practices. The effects of the pandemic were mitigated in part by increased use telemedicine. Future studies may further elucidate COVID-19’s effect on clinical practice and highlight areas for improvement in practice logistics and patient care.
Highlights
The COVID-19 pandemic has significantly affected clinical practice worldwide.[1,2] the degree to which US regions and local healthcare systems were affected varied during the initial pandemic.[3]
Representativeness with AAD membership was confirmed with 95% confidence intervals (CI) (Tables 1,2)
In April 2020 urban practices predicted significantly larger patient volume decreases over the 2 weeks(-45.2%; 95%CI -47.9 to -42.4 vs -31.4%; 95%CI -37.9 to -24.9, p
Summary
The COVID-19 pandemic has significantly affected clinical practice worldwide.[1,2] the degree to which US regions and local healthcare systems were affected varied during the initial pandemic.[3] The purpose of this study was to determine the COVID-19 pandemic’s differential impact on dermatologic outpatient care in urban versus rural areas in the United States. COVID-19 materially delayed patient visits and potential skin cancer biopsies/diagnoses among US dermatology practices. Given a likely heterogenous impact across the US, this study sought to determine COVID-19’s effect on urban versus rural dermatology practices
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
