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

## TL;DR

The study finds that virtual dermatology consultations are more accessible to people in urban and affluent areas, highlighting access inequalities.

## Contribution

The study identifies socioeconomic and geographic disparities in teledermatology access in a specific region.

## Key findings

- Virtual consultations were more common in urban and affluent areas.
- Older and chronically ill patients were more likely to use virtual consultations.
- Inequalities in teledermatology use persist despite its intended role in improving access.

## 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.