Referral Patterns and Diagnostic Concordance in Pediatric Skin Disorders

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care Pub Date : 2024-09-01 DOI:10.1016/j.pedhc.2024.02.001

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引用次数: 0

Abstract

Importance

This study explores referral patterns in pediatric dermatology and assesses the diagnostic concordance between referring and dermatology providers.

Method

This retrospective cross-sectional study utilized referrals to an outpatient pediatric dermatology clinic. The review included patients referred between July 1, 2018 and June 30, 2019. Only patients who completed a clinic visit were included in the diagnostic concordance. Referral and first visit diagnoses were compared to determine concordance.

Results

A total of 8,682 charts were reviewed, and 3,738 completed a clinic visit. The most common referral diagnoses included atopic dermatitis, rash, lesion, melanocytic nevus, and warts. Physicians (78.5%) and APRNs (18.1%) most frequently referred patients. The diagnostic concordance of physicians was 67.1% vs 66.3% for APRNs.

Conclusion

Physicians and APRNs showed similar rates of diagnostic concordance, yet a large proportion of diagnoses were discordant. Primary care providers may benefit from focused education around the most commonly referred and missed diagnoses.

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儿科皮肤病的转诊模式和诊断一致性。

重要性：本研究探讨了儿科皮肤病的转诊模式，并评估了转诊医生和皮肤病医生之间的诊断一致性：这项回顾性横断面研究利用了儿科皮肤病门诊的转诊病例。审查包括2018年7月1日至2019年6月30日期间转诊的患者。只有完成门诊就诊的患者才被纳入诊断一致性研究。对转诊和首次就诊的诊断进行比较，以确定是否一致：共审查了 8,682 份病历，其中 3,738 人完成了门诊。最常见的转诊诊断包括特应性皮炎、皮疹、皮损、黑素细胞痣和疣。医生（78.5%）和助理护士（18.1%）最常转诊病人。医生的诊断一致性为 67.1%，全科护士为 66.3%：结论：医生和全科护士的诊断一致率相似，但有很大一部分诊断不一致。围绕最常见的转诊和漏诊进行重点教育可能会让初级保健提供者受益匪浅。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Health Care NURSING-PEDIATRICS

CiteScore

3.40

自引率

10.70%

发文量

140

审稿时长

24 days

期刊介绍： The Journal of Pediatric Health Care, the official journal of the National Association of Pediatric Nurse Practitioners, provides scholarly clinical information and research regarding primary, acute and specialty health care for children of newborn age through young adulthood within a family-centered context. The Journal disseminates multidisciplinary perspectives on evidence-based practice and emerging policy, advocacy and educational issues that are of importance to all healthcare professionals caring for children and their families.