INCREASING UTILIZATION OF DERMATOLOGISTS BY MANAGED CARE - AN ANALYSIS OF THE NATIONAL AMBULATORY MEDICAL-CARE SURVEY, 1990-1994

Patients with managed care are less likely to see dermatologists for s kin problems than an patients with traditional insurance. Through 1992 , increase in the demand for treatment of skin problems reduced the ef fect of managed care on dermatologists. We assessed the continued impa ct of managed care on visits to dermatologists. Skin disease visits fr om the National Ambulatory Medical Care Survey were analyzed for the y ears 1990-1994. We found that demand for treatment of skin problems di d not rise between 1992 and 1994, but demand for dermatologists' servi ces within the managed care sector more than doubled. In 1994 patients with HMO/prepaid insurance with skin disease were just as likely to s ee a dermatologist as were patients with commercial insurance. Mean vi sit duration for skin problems was 19% longer for nondermatologists th an for dermatologists (p < 0.001). We conclude that dermatologists are more efficient at treating skin disease than nondermatologists and th at utilization of dermatologists within managed care is increasing.