Dermatologic services provided to children and adolescents by primary care and other physicians in the United States.
To determine the frequency and types of pediatric dermatologic problems encountered by primary care physicians, dermatologists, and other physicians, we examined data from the 1990 National Ambulatory Medical Care Survey, a continuing study of physician practice in the United States. In 1990, 163.3 million physician office visits were made by patients 18 years of age or younger for all diagnoses; of these, 126.2 million were to primary care physicians. Among visits to these providers, a primary, secondary, or tertiary cutaneous concern or diagnosis was recorded in 12.3 million visits (9.7%). Of these patients with a primary cutaneous concern, 68% of visits were made to primary care physicians, 21% to dermatologists, and 10% to other physicians. For encounters in which primary care physicians reported a primary dermatologic diagnosis (9.6 million visits, 7.6%), the majority of diagnoses (86-93%) were in one of five categories: skin infections, dermatitis, parasitic infestations, acne, or urticaria. This analysis demonstrates the great frequency with which cutaneous disease occurs in ambulatory medicine, and reinforces the importance of dermatologic education in the training of primary care physicians.
Department of Pediatrics, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157.
D P
DP
Krowchuk
D D
DD
Bradham
A B
AB
Fleischer
D000152:Acne Vulgaris / Q000175:diagnosis; D000293:Adolescent; D000553:Ambulatory Care; D002648:Child; D003872:Dermatitis / Q000175:diagnosis; D003877:Dermatitis, Contact / Q000175:diagnosis; D003880:Dermatology / Q000193:education / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D010372:Pediatrics / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D012871:Skin Diseases / Q000175:diagnosis*; D012874:Skin Diseases, Infectious / Q000175:diagnosis; D012876:Skin Diseases, Parasitic / Q000175:diagnosis; D014481:United States / Q000453:epidemiology; D014581:Urticaria / Q000175:diagnosis