Changing Dermatologic Procedural Patterns in the Medicare Population: A National Trend Analysis

Area of Science:

• Dermatology
• Health Services Research
• Health Policy

Background:

• Comparative trends in basic dermatologic procedures across provider types are not well-documented nationally.
• Dermatologists are trained in diagnosing and treating skin lesions, but procedural data is limited.
• Understanding procedural shifts is crucial for healthcare planning.

Purpose of the Study:

• To analyze trends in common dermatologic procedures among different provider groups.
• To compare procedural volumes among general dermatologists, Mohs surgeons, primary care physicians (PCPs), and nonphysician clinicians (NPCs).
• To identify shifts in procedural distribution over time.

Main Methods:

• Longitudinal analysis of Medicare Public Use Files from 2016 to 2021.
• Examined procedural volumes and proportions across provider types.
• Analyzed procedural trends in relation to geographic and socioeconomic factors.

Main Results:

• Overall dermatologic procedural volume decreased by 3.0%.
• General dermatologists, Mohs surgeons, and PCPs showed declining procedural volumes, while NPCs increased by 57.5%.
• General dermatologists' procedural share decreased, particularly in rural, low-income, and underserved counties.

Conclusions:

• Aggregate procedural volume declined, with a decreasing proportion performed by general dermatologists, Mohs surgeons, and PCPs.
• The rise in NPC procedures may help meet demand but highlights the need for formal training.
• Declining general dermatologist procedures in underserved areas could exacerbate unmet needs.