Wait times for dermatology new patient visits differ by patient sociodemographic and clinical factors

Summary: Abstract Body: Existing disparities in access to dermatologic care contribute to health disparities and disproportionately affect minoritized and marginalized populations. To understand potential causes of these disparities, we examined the associations between patient and clinical characteristics and wait times for dermatology appointments. We conducted a cross-sectional analysis of adults scheduled for medical dermatology new patient visits (NPVs) at the University of Pennsylvania between 2017 and 2023. The primary outcome was time from appointment scheduling to visit, categorized as falling within four weeks vs. more than four weeks. Multivariable logistic regression was used to evaluate the associations between patient sociodemographic and clinical factors and the primary outcome. Analyses were stratified by pre-COVID (2017-2020) and post-COVID (2021-2023) time periods to account for post-pandemic scheduling changes. The study cohort included 40,177 patients. Mean (SD) age was 47 (18) years; 62.5% were female; and racial/ethnic distribution was 52.1% White, 27.1% Black, 6.5% Asian, and 4.6% Hispanic. Overall, 47.8% and 76.7% of patients in the pre-COVID and post-COVID time periods, respectively, were scheduled for an NPV within four weeks. In adjusted analyses, malignant visit diagnosis was most strongly positively associated with having an NPV scheduled within four weeks in both time periods (pre-COVID OR: 1.89; 95% CI: 1.19-3.04; post-COVID: 2.38; 1.27-4.95). Medicaid insurance was negatively associated with the outcome in the pre-COVID period only (pre-COVID: 0.74, 0.67-0.82; post-COVID: 1.07, 0.97-1.19). Among patients with NPVs for benign conditions, Black race was negatively associated with the outcome in the pre-COVID period only (pre-COVID: 0.92, 0.85-0.99; post-COVID: 1.23, 1.13-1.33). Our study identified pre-COVID disparities in wait times for dermatology NPVs that were not present following post-COVID scheduling changes. Nikhita Perry¹, Robert Fitzsimmons¹, Jalin Jordan¹, Amy Wu¹, Ganen Chinniah¹, Benjamin Stone¹, Junko Takeshita¹ 1. University of Pennsylvania, Philadelphia, PA, United States. Minoritized Populations and Health Disparities Research