Wilkinson David, Askew Deborah A, Dixon Anthony
School of Medicine, University of Queensland, Herston, QLD, Australia.
Med J Aust. 2006 Feb 20;184(4):162-4. doi: 10.5694/j.1326-5377.2006.tb00176.x.
To describe the workload profile in a network of Australian skin cancer clinics.
Analysis of billing data for the first 6 months of 2005 in a primary-care skin cancer clinic network, consisting of seven clinics and staffed by 20 doctors, located in the Northern Territory, Queensland and New South Wales.
Consultation to biopsy ratio (CBR); biopsy to treatment ratio (BTR); number of benign naevi excised per melanoma (number needed to treat [NNT]).
Of 69 780 billed activities, 34 622 (49.6%) were consultations, 19 358 (27.7%) biopsies, 8055 (11.5%) surgical excisions, 2804 (4.0%) additional surgical repairs, 1613 (2.3%) non-surgical treatments of cancers and 3328 (4.8%) treatments of premalignant or non-malignant lesions. A total of 6438 cancers were treated (116 melanomas by excision, 4709 non-melanoma skin cancers [NMSCs] by excision, and 1613 NMSCs non-surgically); 5251 (65.2%) surgical wounds were repaired by direct suture, 2651 (32.9%) by a flap (of which 44.8% were simple flaps), 42 (0.5%) by wedge excision and 111 (1.4%) by grafts. The CBR was 1.79, the BTR was 3.1 and the NNT was 28.6.
In this network of Australian skin cancer clinics, one in three biopsies identified a skin cancer (BTR, 3.1), and about 29 benign lesions were excised per melanoma (NNT, 28.6). The estimated NNT was similar to that reported previously in general practice. More data are needed on health outcomes, including effectiveness of treatment and surgical repair.
描述澳大利亚皮肤癌诊所网络的工作量概况。
对2005年上半年一个初级保健皮肤癌诊所网络的计费数据进行分析，该网络由位于北领地、昆士兰和新南威尔士的七家诊所组成，有20名医生。
会诊与活检比率（CBR）；活检与治疗比率（BTR）；每例黑色素瘤切除的良性痣数量（治疗所需数量[NNT]）。
在69780项计费活动中，34622项（49.6%）是会诊，19358项（27.7%）是活检，8055项（11.5%）是手术切除，2804项（4.0%）是额外的手术修复，1613项（2.3%）是癌症的非手术治疗，3328项（4.8%）是癌前或非恶性病变的治疗。共治疗了6438例癌症（116例黑色素瘤通过切除，4709例非黑色素瘤皮肤癌[NMSC]通过切除，1613例NMSC通过非手术治疗）；5251例（65.2%）手术伤口通过直接缝合修复，2651例（32.9%）通过皮瓣修复（其中44.8%是简单皮瓣），42例（0.5%）通过楔形切除修复，111例（1.4%）通过移植修复。CBR为1.79，BTR为3.1，NNT为28.6。
在这个澳大利亚皮肤癌诊所网络中，每三次活检中有一次确诊为皮肤癌（BTR，3.1），每例黑色素瘤约切除29个良性病变（NNT，28.6）。估计的NNT与之前在全科医疗中报告的相似。需要更多关于健康结果的数据，包括治疗和手术修复的有效性。
