Urgency vs triage prioritisation: appropriateness of referrer-rated urgency of referrals to a public dermatology service.

Abstract

Aim: To characterise the appropriateness of community referrer-rated urgency among dermatology referrals.

Method: Using e-referral data from a month representative of volume and service provision in a tertiary dermatology service, referrer-rated urgency and triage priority assigned by two specialist dermatologists were compared to determine appropriateness. Descriptive analysis was conducted to quantify the proportion of appropriately and inappropriately assigned urgency in priority populations of women, Māori and Pacific peoples and paediatric patients.

Results: One-third of general dermatology referrals, and nearly one in six referrals of suspected skin cancers, had an inappropriately assigned urgency. A quarter of general dermatology and most melanoma referrals had urgency lower than triage priority. Māori and Pacific patients were under-represented in the proportion of referrals received by ethnicity when comparing to national and provincial population estimates. However, no significant disparities in appropriateness of urgency across ethnicity were observed, and the same was seen for female and paediatric patients.

Conclusion: Our study adds to the limited research on the appropriateness of referrer-rated urgency. We have pointed out that artificial intelligence (AI) has significant potential to improve the prioritisation of referrals by identifying melanoma and severe skin diseases.