Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 14;12(6):659.
doi: 10.3390/healthcare12060659.

Virtual Consultation in Dermatology: Access Inequalities According to Socioeconomic Characteristics and the Place of Residence

Affiliations

Virtual Consultation in Dermatology: Access Inequalities According to Socioeconomic Characteristics and the Place of Residence

Almudena Marco-Ibáñez et al. Healthcare (Basel). .

Abstract

Virtual consultation has been implemented as a tool to improve the cooperation and coordination between primary care and other specialties. However, in its use in dermatology, inequities have been described. The aim of this study was to identify individual and geographical factors affecting the likelihood of accessing this resource. We conducted a cross-sectional study. The study population was individuals living in Aragón, a region in the north-east of Spain, who were users of the Aragon Health Service in 2021. To explore the differences in individual and area characteristics, between patients with virtual and non-virtual dermatology consultation, we performed bivariate analyses. To analyse the use of virtual consultation in dermatology, a multilevel methodology stratified by sex was developed. We analysed 39,174 dermatology visits, with 16,910 being virtual (43.17%). The rates of virtual consultation were higher in urban areas and the most affluent areas, for older persons, chronic complex patients and people with more advantageous socioeconomic positions. The best multilevel model conducted showed inequalities by socioeconomic position and area of residence. There are individual and area inequalities in the use of teledermatology. As this tool should improve equity of access, teledermatology interventions must address and adapt to the needs of the local patient population.

Keywords: inequalities; multilevel model; teledermatology; virtual consultation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Geographic distribution of virtual and non-virtual consultation in (a) Aragón and (b) in the city of Zaragoza.
Figure 2
Figure 2
Random effects by (a) basic healthcare area deprivation and (b) by depopulation level of the basic healthcare area.
Figure 3
Figure 3
Random effects by (a) basic healthcare area deprivation and (b) by depopulation level of the basic healthcare area in men.
Figure 4
Figure 4
Random effects by (a) basic healthcare area deprivation and (b) by depopulation level of the basic healthcare area in women.

References

    1. Marco-Ibáñez A., Aguilar-Palacio I., Aibar C. Does virtual consultation between primary and specialised care improve healthcare quality? A scoping review of healthcare quality domains assessment. BMJ Open Qual. 2023;12:e002388. doi: 10.1136/bmjoq-2023-002388. - DOI - PMC - PubMed
    1. Anderson D., Villagra V.G., Coman E., Ahmed T., Porto A., Jepeal N., Maci G., Teevan B. Reduced cost of specialty care using electronic consultations for medicaid patients. Health Aff. 2018;37:2031–2036. doi: 10.1377/hlthaff.2018.05124. - DOI - PubMed
    1. Liddy C., Joschko J., Guglani S., Afkham A., Keely E. Improving Equity of Access through Electronic Consultation: A Case Study of an eConsult Service. Front. Public Health. 2019;7:279. doi: 10.3389/fpubh.2019.00279. - DOI - PMC - PubMed
    1. Wurm E.M., Hofmann-Wellenhof R., Wurm R., Soyer H.P. Telemedicine and teledermatology: Past, present and future. JDDG J. Dtsch. Dermatol. Ges. 2008;6:106–112. doi: 10.1111/j.1610-0387.2007.06440.x. - DOI - PubMed
    1. Augustin M., Wimmer J., Biedermann T., Blaga R., Dierks C., Djamei V., Elmer A., Elsner P., Enk A., Gass S., et al. Praxis der Teledermatologie. JDDG J. Dtsch. Dermatol. Ges. 2018;16:6–57. doi: 10.1111/ddg.13512. - DOI - PubMed