Disparities and determinants of dermatology consultation duration: The influence of sex, age, race, and insurance in a multivariate analysis of NAMCS (2011–2019)
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Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: Health disparities impact access to care, patient-physician interactions, and satisfaction, with race, socioeconomic status, and insurance being key determinants. Visit length serves as an objective marker of communication quality, where shorter visits correlate with reduced preventive care utilization. We evaluated factors influencing disparities in dermatology consultation times using National Ambulatory Medical Care Survey (NAMCS) data (2011–2019). Visits were categorized based on dermatologic conditions without coexisting diagnoses. Gender: Males had significantly longer consultations for common skin infections (p=0.03) and across all dermatologic conditions (+1.34 minutes, p<0.01). Race: No significant differences were found in condition-specific comparisons between the races. However, across all dermatologic conditions, Black patients had shorter visits (-1.85 minutes, p=0.02). Insurance: When aggregated, patients with public insurance had longer visits than those with private insurance (+1.63 minutes, p<0.01). Age: Younger patients (15–24 years) had longer visits for common infections (p=0.047), while adults ≥75 years experienced extended consultations across all dermatologic conditions (+3.83 minutes, p<0.01). Temporal trends: Overall visit durations remained stable. However, consultations for dermatitis/rash declined by 3.13 minutes in 2018–2019 (p < 0.01), and for malignant neoplasms, decreased by 6.51 minutes in 2013–2014 (p<0.01) and 6.45 minutes in 2018–2019(p=0.011). Race- time interactions: Black patients in 2015–2016 had significantly shorter visits for common skin infections (-8.88 minutes, p<0.001) and in 2018–2019 (-9.92 minutes, p<0.001), highlighting potential worsening disparities over time. Similar trend was observed for non-malignant skin neoplasms, but not across aggregated conditions. Our findings suggest that longer consultation durations were observed among males, White patients, publicly insured individuals, and older adults, while racial disparities in visit lengths fluctuated over time. Arash Pour Mohammad<sup>1</sup>, Gordon H. Bae<sup>1</sup> 1. Stanford University School of Medicine, Stanford, CA, United States. Clinical Research: Epidemiology and Observational Research