Barbieri John S, Mostaghimi Arash, Noe Megan H, Margolis David J, Gelfand Joel M
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
JAAD Int. 2020 Dec 1;2:31-36. doi: 10.1016/j.jdin.2020.10.010. eCollection 2021 Mar.
Skin diseases, such as psoriasis, hidradenitis suppurativa, acne, and alopecia areata, have increasingly been linked to systemic and mental health comorbidities, such as depression. Although identification and management of these comorbidities is typically a part of primary care, some patients might not have an established relationship with a primary care provider and may only be seeing their dermatologist.
To examine the frequency with which dermatologists are the main contact within a health care system for patients with these chronic skin conditions.
We performed a retrospective cohort study using Optum's deidentified Clinformatics Data Mart Database. The primary outcome was the proportion of patients who established care with a dermatologist and had no encounters with a primary care provider during the subsequent year after this dermatology encounter.
Across each of the skin diseases evaluated, 21.6%-31.2% of men and 16.9%-26.2% of women had no primary care visits in the subsequent year after establishing care with their dermatologist.
For many patients with chronic skin diseases, their dermatologist might be their only source of contact with the health care system. There may be an opportunity for dermatologists to improve the quality of care for our patients by screening for associated comorbidities.
银屑病、化脓性汗腺炎、痤疮和斑秃等皮肤病与全身性和心理健康合并症（如抑郁症）的关联日益增加。虽然识别和管理这些合并症通常是初级保健的一部分，但一些患者可能与初级保健提供者没有既定的关系，可能只看皮肤科医生。
研究皮肤科医生作为这些慢性皮肤病患者在医疗系统中的主要联系人的频率。
我们使用Optum的去识别化临床信息数据集市数据库进行了一项回顾性队列研究。主要结局是在皮肤科就诊后次年与皮肤科医生建立护理关系且未与初级保健提供者接触的患者比例。
在评估的每种皮肤病中，21.6%-31.2%的男性和16.9%-26.2%的女性在与皮肤科医生建立护理关系后的次年没有进行初级保健就诊。
对于许多慢性皮肤病患者来说，他们的皮肤科医生可能是他们与医疗系统的唯一联系来源。皮肤科医生通过筛查相关合并症来提高我们患者的护理质量可能存在机会。
