An Australian tertiary hospital analysis of outpatient dermatology clinical and demographic characteristics

Abstract

Objectives 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. Methods 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. Results 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. Conclusions 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.

Analysis of patient demographics and attendance at a Far North Queensland public dermatology outpatient clinic

“…Furthermore, most category 3 patients in 2020 (57.1%) and 2021 (61.3%) were also seen in time, marking an improvement from the earlier years of the study period. This is compared to the tertiary hospital in Brisbane which found that only the majority of category 3 patients (60%) were seen within the expected timeframe (365 days) during its 4‐year study period 9 . While it is commendable that the majority of category 1 and 3 patients were seen in time during 2020 and 2021 at the Cairns Hospital, further strategies should be considered to address the wait times that patients, particularly category 2 patients, experience.…”

“…One study, which analysed the dermatology outpatient demographics at a metropolitan tertiary hospital in Brisbane, Queensland, found that during the 4-year period between January 2016 and December 2019, 7140 new patients were referred. 9 Similarly, another study that analysed the dermatological services offered at a rural tertiary hospital in the Northern Territory, determined that 330 new appointments were scheduled in a 1-year period in 2016. 10 Given that Cairns Hospital is a regional non-tertiary hospital and that the population within its catchments is projected to continually grow, its level of resourcing should be reviewed so that it is able to meet this demand.…”

“…While the Department is relatively small, it received a high volume of new referrals (3923 in the study period) when compared to other public dermatology outpatient clinics and their respective level of resources. One study, which analysed the dermatology outpatient demographics at a metropolitan tertiary hospital in Brisbane, Queensland, found that during the 4‐year period between January 2016 and December 2019, 7140 new patients were referred 9 . Similarly, another study that analysed the dermatological services offered at a rural tertiary hospital in the Northern Territory, determined that 330 new appointments were scheduled in a 1‐year period in 2016 10 .…”

“…This is compared to the tertiary hospital in Brisbane which found that only the majority of category 3 patients (60%) were seen within the expected timeframe (365 days) during its 4-year study period. 9 While it is commendable that the majority of category 1 and 3 patients were seen in time during 2020 and 2021 at the Cairns Hospital, further strategies should be considered to address the wait times that patients, particularly category 2 patients, experience. For example, further research should be conducted to assess the cost-benefit of allocating additional resources and funding towards the Department and determining whether it could assist in addressing this issue.…”

Store‐and‐forward (asynchronous) doctor‐to‐dermatologist non‐skin cancer specific teledermatology services in Australia: A scoping review

“…However, the average time to specialist advice reported in the studies utilising a SAFT service was faster compared to the average time required for patients referred to a large public dermatology clinic to be seen face-to-face. 54 Only a small proportion of SAFT patients were recommended a subsequent face-to-face appointment thereby allowing more patients to be adequately managed in primary practice ultimately reducing the burden of the dermatology outpatient setting and preventing patients the need to travel to metropolitan centres for care. Furthermore, triaging dermatological patients, and determining which patients need subsequent face-to-face review, could increase efficiency of health-care systems.…”