Analysing referral patterns from a primary dermatological clinic to other medical institutions for further care: A survey on patients with certain skin diseases in Japan

Abstract

Background

Various skin diseases exist; some require specialist treatment. Consequently, patients with these conditions are often referred from primary dermatological clinics to other medical institutions for further secondary or tertiary care. However, it has yet to be fully evaluated at primary dermatological clinics which skin conditions necessitate such referrals.

Objectives

This study aims to identify skin conditions that often require further care when treated at a primary dermatological clinic.

Methods

This study enroled 14,306 patients who had visited the Ueo Dermatology Clinic (a primary dermatological clinic in Saiki City, Oita prefecture, Japan) from 1 January 2020 to 31 December 2022. The following clinical information was examined: the primary disease, age, sex, whether referrals (general or emergency) were made after the clinic visit or not, and the reasons for the referrals.

Results

'Eczema and dermatitis' was the most frequent category in the clinic, although the referral rates for this category were not exceptionally high compared to other categories. A large number of emergency referrals was observed for 'Viral infections (herpes zoster),' 'Drug-induced skin reactions,' and 'Bacterial infections (cellulitis)'; a large number of general referrals was observed for 'Malignant skin tumours and melanomas' and 'Benign skin tumours.' Although low numbers, the rates for general and emergency referrals were high in the categories of 'Blistering Diseases,' 'Connective Tissue Diseases,' and 'Vasculitis, Purpura, and Other Vascular Diseases.' In an analysis of the reasons for the referrals, the following reasons ranked highest: requirement for high-level medical treatment, surgical operation, or hospitalisation, and consultation with doctors in departments other than dermatology.

Conclusions

This study identified several skin conditions often requiring additional care when treated at a primary dermatological clinic. Based on these findings, seamless cooperation between primary clinics and specialised medical institutions is anticipated.