Quantifying the Barriers To Clinic Visits

While demand for visits to the dermatology clinic are on the rise, so too are barriers for patients in the form of both direct and indirect costs. Dermatology may serve as a case study in barriers to specialty care as nationally there are long waits to see providers. Therefore, patients may have to travel further to find providers, leading to higher associated time, travel, and monetary costs. In addition, clinic visits cost patients an average of 30% more per visit and 60% of visits come with associated out-of-pocket expenses.

A recent study looked at direct and indirect patient costs, including opportunity costs and time burden that are linked with dermatology clinic visits to better understand the impact of these factors on health care access.

Using a single-institution survey, authors performed an evaluation of the direct and indirect costs to patients visiting an outpatient dermatology clinic in Boston, Massachusetts. Results showed that about 20% of patients spent more than an hour to travel to the clinic, while the face-to-face visit averaged about 35 minutes. More than three-quarters of patients needed to take time off of work to come to the visit. On average, the time spent traveling to the clinic was twice as much as the time spent with the provider. Patients reported their costs for the visit (mostly as opportunity costs from lost wages) at about $190. The patients reported that despite these costs, most were happy with their current provider and only about 30% would prefer to see a provider closer to home. However, patients with additional out-of-pocket costs were significantly less likely to prefer their current care provider compared to patients with no out-of-pocket costs. As travel time increased, preference for that provider decreased; patients who traveled 60 minutes or more roundtrip were 71% less likely to choose current provider care.

Overall, the study showed that patients incur significant costs of both time and money when seeking dermatologic care. The authors suggest that these costs affect patient provider preference and may pose barriers to necessary medical care. They note that recognizing both direct and indirect patient costs is helpful when considering whether there should be changes in health care delivery, such as increased cost-saving alternatives such as telecommunication utilization.