Krowchuk D P, Bradham D D, Fleischer A B
Department of Pediatrics, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157.
Pediatr Dermatol. 1994 Sep;11(3):199-203. doi: 10.1111/j.1525-1470.1994.tb00586.x.
To determine the frequency and types of pediatric dermatologic problems encountered by primary care physicians, dermatologists, and other physicians, we examined data from the 1990 National Ambulatory Medical Care Survey, a continuing study of physician practice in the United States. In 1990, 163.3 million physician office visits were made by patients 18 years of age or younger for all diagnoses; of these, 126.2 million were to primary care physicians. Among visits to these providers, a primary, secondary, or tertiary cutaneous concern or diagnosis was recorded in 12.3 million visits (9.7%). Of these patients with a primary cutaneous concern, 68% of visits were made to primary care physicians, 21% to dermatologists, and 10% to other physicians. For encounters in which primary care physicians reported a primary dermatologic diagnosis (9.6 million visits, 7.6%), the majority of diagnoses (86-93%) were in one of five categories: skin infections, dermatitis, parasitic infestations, acne, or urticaria. This analysis demonstrates the great frequency with which cutaneous disease occurs in ambulatory medicine, and reinforces the importance of dermatologic education in the training of primary care physicians.
为了确定初级保健医生、皮肤科医生及其他医生所遇到的儿科皮肤问题的频率和类型，我们研究了1990年全国门诊医疗调查的数据，这是一项对美国医生执业情况的持续研究。1990年，18岁及以下患者因各种诊断进行了1.633亿次门诊就诊；其中，1.262亿次是去看初级保健医生。在这些医生的就诊中，有1230万次就诊（9.7%）记录了主要、次要或三级皮肤问题或诊断。在这些有主要皮肤问题的患者中，68%的就诊是去看初级保健医生，21%是去看皮肤科医生，10%是去看其他医生。对于初级保健医生报告有主要皮肤诊断的就诊（960万次就诊，7.6%），大多数诊断（86 - 93%）属于以下五类之一：皮肤感染、皮炎、寄生虫感染、痤疮或荨麻疹。这项分析表明了皮肤病在门诊医疗中出现的频率很高，并强化了皮肤科教育在初级保健医生培训中的重要性。
