苏格兰东南部皮肤病学工作量研究：30 年分析。

The south-east Scotland dermatology workload study: 30 years' analysis.

机构信息

Department of Dermatology, Royal Infirmary, Lauriston Buildings, Lauriston Place, Edinburgh EH3 9HA, UK.

出版信息

Br J Dermatol. 2012 Jul;167(1):123-30. doi: 10.1111/j.1365-2133.2012.10906.x. Epub 2012 Jun 1.

DOI:10.1111/j.1365-2133.2012.10906.x

PMID:22372993

Abstract

BACKGROUND

Dermatological activity data have been collected for the same region of south-east Scotland (population 1·24 million), approximately every 5 years, since 1981. This has allowed assessment of trends in demand from primary and secondary care, and activity within secondary care dermatology services, assisting planning of dermatological services.

OBJECTIVES

To quantify dermatology outpatient workload across the same population to allow comparison with previous studies for trends in practice.

METHODS

During November 2010, a standardized proforma was completed for all National Health Service and private practice dermatology outpatient consultations. Demographic data, source and reason for referral, diagnoses, investigations, treatments and disposal were recorded, and comparisons made with five previous studies.

RESULTS

A total of 5470 consultations were recorded: 2882 new and 2588 review patients (new to review ratio 1 : 0·9, male to female 1 : 1·3, mean age 49 years, range 1 month to 101 years). Ninety-one per cent of referrals came from primary care and 9% from secondary care. Fifty-eight per cent of referrals were for diagnosis and 32% for hospital management. Diagnostic concordance between referrer and dermatologist ranged from 94% for acne to 14% for melanoma. Benign tumours accounted for 30% of referrals, malignant tumours 13%, dermatitis 13·3%, psoriasis 6·2% and acne/rosacea 5%. The referral rate rose to 23·2/1000 population per annum, with the increase coming mainly from primary care.

CONCLUSIONS

Demand for dermatology continues to increase: new referrals have risen by 134% in 30 years, with a 36% increase in the last 5 years, despite corresponding population increases of 5·3% and 3%, respectively.

摘要

背景

自 1981 年以来，苏格兰东南部（人口 124 万）的同一地区一直在每 5 年左右收集一次皮肤科活动数据。这使得人们能够评估初级和二级保健需求的趋势，以及二级保健皮肤科服务的活动情况，从而协助规划皮肤科服务。

目的

量化整个人群的皮肤科门诊工作量，以便与之前的研究进行比较，了解实践中的趋势。

方法

在 2010 年 11 月期间，对所有 NHS 和私人执业的皮肤科门诊咨询记录使用标准化表格。记录人口统计学数据、转诊来源和原因、诊断、检查、治疗和处理方式，并与之前的五项研究进行比较。

结果

共记录了 5470 次就诊：2882 次新患者和 2588 次复诊患者（新患者与复诊患者的比例为 1:0.9，男女比例为 1:1.3，平均年龄为 49 岁，范围为 1 个月至 101 岁）。91%的转诊来自初级保健，9%来自二级保健。58%的转诊是为了诊断，32%是为了住院治疗。转诊医生和皮肤科医生的诊断一致性从痤疮的 94%到黑色素瘤的 14%不等。良性肿瘤占转诊的 30%，恶性肿瘤占 13%，皮炎占 13.3%，银屑病占 6.2%，痤疮/酒渣鼻占 5%。皮肤科就诊率上升至每年 23.2/1000 人，在过去 30 年中增加了 134%，在过去 5 年中增加了 36%，而相应的人口增长率分别为 5.3%和 3%。