Race and appointment availability influence continuity of care for chronic inflammatory skin disease: A cross-sectional study of United States practice data.

Abstract

In the management of chronic inflammatory skin disease (CISD), continuity of care may influence the achievement of long-term disease control. Barriers to care have been identified in this population, which may leave some patients more vulnerable to loss of follow-up. We aim to identify predictors of continuity of care for CISD patients across demographic groups and health care practice types in the United States. A cross-sectional study of National Ambulatory Medical Care Survey data was conducted on US outpatient CISD visits between 2011 and 2019 including a primary diagnosis of psoriasis, atopic dermatitis, acne, or rosacea. A total of 2747 visits, estimating 75.4 (95% CI: 70.9-79.9) million CISD encounters were identified during the period. Multivariate regression showed that Black patients had lower odds of establishing continuity of care relative to White patients (P < .01). Practices offering same-day visits had greater odds for patients with continuity (P < .05). Conversely, practices with lower overall wait times (≤1 month) were less likely to be associated with continuity of care (P < .01). Disease severity data were unavailable. Both patient race and appointment availability predict differences in continuity of care, suggesting vulnerabilities may exist for some CISD patients requiring follow-up.