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The South-East Scotland Dermatology Workload Study: 30 years analysis.

Br J Dermatol. 2012 Feb 28;

Authors: Holme SA, Scott-Lang VE, Ooi ET, Matthews AG, Darling MI, Needham D, McCormack SK

Abstract
Background:  Dermatological activity data has been collected for the same region of south-east Scotland (population of 1.24 million), approximately every five 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 standardised 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:  5470 consultations were recorded: 2882 new and 2588 review patients (new:review ratio 1:0.9, male:female 1:1.3, mean age 49 years, range 1 month - 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 97% 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.

PMID: 22372993 [PubMed - as supplied by publisher]

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