Dermatology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Australas J Dermatol. 2021 Nov;62(4):e488-e495. doi: 10.1111/ajd.13677. Epub 2021 Aug 16.
Literature on dermatology outpatient demographic and clinical data is limited, and the few studies on this topic are mainly conducted overseas, with medical systems and case mix different to Australia. This study presents demographic data relating to dermatology public outpatient referrals to a tertiary hospital in Brisbane, Australia, and determines what additional structured data should be collected to formulate and evaluate initiatives to address service issues such as referral quality, triage process and wait times.
A four-year retrospective audit was undertaken, summarising all referrals (n = 7140) and clinical dermatology encounters (n = 53 844) between January 2016 and December 2019 at Princess Alexandra Hospital (PAH), the largest hospital in Metro South Health (MSH), serving a population of one million. PAH has one of the two largest public dermatology clinics in Queensland and is the only dermatology service within MSH.
Patient demographic data, wait time by triage category, referral rates over time and encounter durations were collected. Structured diagnostic data (e.g. ICD-10 coding) of the provisional diagnosis, comorbidities, medications and the final diagnosis are not collected in a structured format and would be a valuable addition.
The clinical burden of public dermatology is increasing. Both collection and analysis of structured data pertaining to the referrals and encounters are important to help formulate, implement and evaluate initiatives that aim to improve health service provision in this area.
皮肤科门诊患者人口统计学和临床数据的相关文献有限，且该主题的少数研究主要在海外进行，其医疗体系和病例组合与澳大利亚不同。本研究介绍了澳大利亚布里斯班一家三级医院皮肤科门诊转诊的人口统计学数据，并确定应收集哪些额外的结构化数据，以制定和评估解决服务问题（如转诊质量、分诊流程和等待时间）的举措。
本研究进行了为期四年的回顾性审计，总结了 2016 年 1 月至 2019 年 12 月期间在Princess Alexandra Hospital（PAH）的所有转诊（n=7140）和皮肤科临床就诊（n=53844）情况，PAH 是 Metro South Health（MSH）最大的医院，服务人群达 100 万。PAH 拥有昆士兰州两家最大的公立皮肤科诊所之一，也是 MSH 唯一的皮肤科服务机构。
收集了患者人口统计学数据、按分诊类别划分的等待时间、随时间推移的转诊率以及就诊时长。未以结构化格式收集临时诊断、合并症、药物和最终诊断等结构化诊断数据（例如 ICD-10 编码），这将是一个有价值的补充。
公共皮肤科的临床负担正在增加。收集和分析与转诊和就诊相关的结构化数据对于制定、实施和评估旨在改善该领域卫生服务提供的举措非常重要。
