+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Lower utilization of dermatologists in managed care: Despite growth in managed care, visits to dermatologists did not decrease: An analysis of National Ambulatory Medical Care Survey data, 1990-1992



Lower utilization of dermatologists in managed care: Despite growth in managed care, visits to dermatologists did not decrease: An analysis of National Ambulatory Medical Care Survey data, 1990-1992



Journal of Investigative Dermatology 107(6): 860-864



Growth of managed care and the decline of direct access are two of the major issues confronting dermatology. Previous study has demonstrated that patients in managed care are less likely than patients with indemnity insurance to see a dermatologist for skin problems, and it was predicted that this would result in a slowing in the demand for dermatologist services. To examine whether the changing health-care environment has resulted in fewer visits to dermatologists, we used National Ambulatory Medical Care Survey data from the years 1990-1992 to examine utilization of dermatologist services over a period in which managed care grew by 32%. Patients with HMO/prepaid insurance were less likely to have their skin care provided by dermatologists than patients with commercial insurance (Blue Cross/Blue Shield and other commercial carriers) or Medicare. A reduction in the number of visits to dermatologists was observed among patients with HMO/prepaid insurance despite the growth in HMO/prepaid insurance as a form of payment; when all payors were considered, however, the number of visits to dermatologists increased from the 1989 level, reaching a plateau in 1992. The number of visits for skin disease to all physicians increased from 56.5 million to 63.5 million, whereas the proportion of this care delivered by dermatologists decreased from 39.6% to 37.9%. The overall increase in visits for skin conditions tempered the reduction in demand for dermatology services expected with the growing transition to managed care.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 008977652

Download citation: RISBibTeXText

PMID: 8941675

DOI: 10.1111/1523-1747.ep12331162


Related references

Increasing utilization of dermatologists by managed care: An analysis of the National Ambulatory Medical Care Survey, 1990-1994. Journal of the American Academy of Dermatology 37(5 Part 1): 784-788, 1997

Dermatologists are more time-efficient than nondermatologists in the care of skin disease The National Ambulatory Medical Care Survey, 1990-1994. Journal of Investigative Dermatology 110(2): 199, 1998

Effects of Managed Care on the Length of Time That Elderly Patients Spend with Physicians during Ambulatory Visits: National Ambulatory Medical Care Survey. Medical Care 40(7): 606-613, 2002

Effects of managed care on the length of time that elderly patients spend with physicians during ambulatory visits: National Ambulatory Medical Care Survey. Medical Care 40(7): 606-613, 2002

Office visits to dermatologists: National Ambulatory Medical Care Survey, United States, 1989-90. Advance Data 1994(240): 1-12, 1994

Severe lower limb cellulitis is best diagnosed by dermatologists and managed with shared care between primary and secondary care. British Journal of Dermatology 164(6): 1326-1328, 2011

Increasing utilization of dermatologists by managed care. Journal of Investigative Dermatology 108(4): 675, 1997

Characteristics of office-based physician visits for cutaneous fungal infections. an analysis of 1990 to 1994 National Ambulatory Medical Care Survey Data. Cutis 69(3): 191-8, 201-2, 2002

Drug utilization in office visits to primary care physicians: National Ambulatory Medical Care Survey, 1980. Advance Data 1982(86): 1-16, 1982

Sex differences in ambulatory visits for chronic obstructive pulmonary disease, based on the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey from 1995 to 2004. Respiratory Care 53(11): 1461-1469, 2008

The impact of managed care to dermatologists when providing care for the indigent population. Journal of Investigative Dermatology 122(3): A66, 2004

Statin Prescribing Patterns: An Analysis of Data From Patients With Diabetes in the National Hospital Ambulatory Medical Care Survey Outpatient Department and National Ambulatory Medical Care Survey Databases, 2005-2010. Clinical Therapeutics 37(6): 1329-1339, 2016

Ambulatory primary care medical education in managed care and non-managed care settings. Family Medicine 28(7): 478-483, 1996

Anxiety and unrecognized high blood pressure in U.S. ambulatory care settings: an analysis of the 2005 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. International Journal of Psychiatry in Medicine 38(1): 91, 2008

Comorbidity of rosacea and depression: an analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey--Outpatient Department data collected by the U.S. National Center for Health Statistics from 1995 to 2002. British Journal of Dermatology 153(6): 1176-1181, 2005