Courtney Kenyon

Background: Little is known about the degree of health-related quality of life (HRQL) that patients being seen at rural outreach clinics experience, nor the impact these clinics can have on HRQL.

Objective: To assess the degree of HRQL impact that rural patients experience and assess if the amount of time required to attend an outreach clinic or travel to the University impacts patient’s perception of HRQL.

Methods: Patients who attended dermatology outreach clinics located in Elko, NV and Rock Springs, WY were surveyed over a one year period. HRQL was assessed using the Skindex-16. Associations between Skindex-16 domain scores and demographic and disease factors were assessed using linear regression.

Results: 137 patients responded to the survey (mean age 56.4, 66% female) providing 150 surveys. When attending the rural outreach clinics, the majority of patients required less than 4 hours to complete their visit (68/93 responses, 73%) whereas, the majority required a day or more to travel to the University of Utah (75/120 responses, 63%). Median Skindex-16 scores were: Emotions = 33 (interquartile range = 7.0-67.0); Symptoms = 25.0 (4.0-50.0); Functioning = 3.0 (0.0-33.0). The emotions domain was significantly higher than other domains (multivariate test of means p<0.0001). Numerically, Skindex-16 scores tended to be higher for patients living further away from clinics, though this difference was not statistically significant.

Conclusions: Patients seen at rural outreach clinics experience significant HRQL impairment. This study underscores the role of outreach in addressing the healthcare needs of rural populations, who face burdensome time constraints and significant HRQL impairment from untreated dermatologic disease.