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西班牙的门诊皮肤科诊断:国家DIADERM随机抽样项目的结果

Outpatient Dermatological Diagnoses in Spain: Results From the National DIADERM Random Sampling Project.

作者信息

Buendía-Eisman A, Arias-Santiago S, Molina-Leyva A, Gilaberte Y, Fernández-Crehuet P, Husein-ElAhmed H, Viera-Ramírez A, Fernández-Peñas P, Taberner R, Descalzo M Á, García-Doval I

机构信息

Facultad de Medicina, Universidad de Granada, Granada, España.

Facultad de Medicina, Universidad de Granada, Granada, España; Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, España.

出版信息

Actas Dermosifiliogr (Engl Ed). 2018 Jun;109(5):416-423. doi: 10.1016/j.ad.2018.02.003. Epub 2018 Mar 20.

Abstract

INTRODUCTION

Dermatologists perform most of their work in outpatient or private clinics. Data on the diagnoses made by dermatologists in these settings are lacking, however, as outpatient activity, unlike hospital activity, is difficult to code. The aim of this study was to analyze the diagnoses made by members of the Spanish Academy of Dermatology and Venereology (AEDV) at dermatology clinics in Spain.

METHODOLOGY

We selected a random sample of AEDV dermatologists drawn from the AEDV list and stratified by geographic area. The selected dermatologists received instructions on how to collect the data required. Each participant recorded the diagnosis reached and other data for patients seen during 2 specified periods: 3 days in January and 3 days in May. The diagnoses were subsequently coded by a dermatologist expert in applying the International Classification of Diseases (10th revision). In view of the complex nature of the sample, data were analyzed with standard error and finite population corrections.

RESULTS

The sample consisted of 124 dermatologists. Of these, 65% participated in the first phase of the study and 59% in the second. An estimated 621 562 patients (95% CI, 368 130-874 995) visit the dermatologist every month in Spain. This is the equivalent of 28 (25-31) patients per day per clinic. The most common diagnosis recorded was actinic keratosis, followed by basal cell carcinoma and melanocytic nevus. The vast majority of visits took place at the clinic, but 1% of patients (0.3%-3%) were assessed using teledermatology.

CONCLUSIONS

This is the first study in Spain to analyze diagnoses made by AEDV members at outpatient dermatology clinics. Our findings show a high volume of activity and will be useful for guiding health care planning, resource use, and future studies.

摘要

引言

皮肤科医生的大部分工作是在门诊或私人诊所进行的。然而,由于门诊活动与医院活动不同,难以进行编码,因此缺乏皮肤科医生在这些环境中做出的诊断数据。本研究的目的是分析西班牙皮肤病学和性病学学会(AEDV)成员在西班牙皮肤科诊所做出的诊断。

方法

我们从AEDV名单中随机抽取了一批皮肤科医生样本,并按地理区域进行分层。选定的皮肤科医生收到了关于如何收集所需数据的指示。每位参与者记录了在两个特定时间段内就诊患者的诊断结果和其他数据:1月的3天和5月的3天。随后,由一位擅长应用国际疾病分类(第10版)的皮肤科专家对诊断结果进行编码。鉴于样本的复杂性,使用标准误差和有限总体校正对数据进行分析。

结果

样本包括124名皮肤科医生。其中,65%的人参与了研究的第一阶段,59%的人参与了第二阶段。据估计,西班牙每月有621562名患者(95%CI,368130 - 874995)看皮肤科医生。这相当于每个诊所每天有28(25 - 31)名患者就诊。记录的最常见诊断是光化性角化病,其次是基底细胞癌和黑素细胞痣。绝大多数就诊发生在诊所,但1%的患者(0.3% - 3%)通过远程皮肤病学进行评估。

结论

这是西班牙第一项分析AEDV成员在门诊皮肤科诊所做出的诊断的研究。我们的研究结果显示了大量的活动,将有助于指导医疗保健规划、资源利用和未来的研究。

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