Demographic Characteristics and Management of Uninsured Patients with a History of Melanoma

Abstract

Aims and Objectives
Patients diagnosed with malignant melanoma often undergo regular follow-up care and skin checks to reduce the likelihood of
recurrence. Yearly exams are more inconsistent and likely to be missed due to a lack of healthcare access and resources among
the uninsured population. This study determined demographic characteristics of uninsured patients with a history of malignant
melanoma. Follow-up was assessed in order to improve and ensure the highest quality of long-term care.
Methods
Demographics and chronic disease diagnoses were extracted from 8,857 patients managed at eight free-clinics from the Tampa
Bay Area during 2016 and 2017. Patients diagnosed with malignant melanoma were specifically chosen for further chart review. A
retrospective analysis of the follow-up care and health outcomes are reported.
Results
A total of 200 of 8,857 reported a history of malignancy; ten patients (5%) were diagnosed with malignant melanoma. The average
age of these patients was 52-years-old, 70% (N=7) of whom were female. Initial treatment for 2 patients (20%) was surgical
excision. Remaining patients were either observed (N=2) or did not mention treatment to their free clinic provider (N=6). Postoperative
follow-up for recurrent lesions varied between patients but a commonly cited reason that prevented proper follow-up
with a dermatologist in eight of the ten patients (80%) was financial restraint.
Conclusions
Free-clinics should be cognizant of local dermatologists who provide subsidized services to those in need due to the higher
prevalence of melanoma among the uninsured. Patients should also be directed to free clinics immediately after surgery to receive
recommended follow-up skin checks. With education, free-clinics can deliver higher quality dermatology management to patients
by following recommended standards.