Skin cancer clinics in Australia: workload profile and performance indicators from an analysis of billing data.
OBJECTIVE
To describe the workload profile in a network of Australian skin cancer clinics.


METHODS
Analysis of billing data for the first 6 months of 2005 in a primary-care skin cancer clinic network, consisting of seven clinics and staffed by 20 doctors, located in the Northern Territory, Queensland and New South Wales.


METHODS
Consultation to biopsy ratio (CBR); biopsy to treatment ratio (BTR); number of benign naevi excised per melanoma (number needed to treat [NNT]).


RESULTS
Of 69 780 billed activities, 34 622 (49.6%) were consultations, 19 358 (27.7%) biopsies, 8055 (11.5%) surgical excisions, 2804 (4.0%) additional surgical repairs, 1613 (2.3%) non-surgical treatments of cancers and 3328 (4.8%) treatments of premalignant or non-malignant lesions. A total of 6438 cancers were treated (116 melanomas by excision, 4709 non-melanoma skin cancers [NMSCs] by excision, and 1613 NMSCs non-surgically); 5251 (65.2%) surgical wounds were repaired by direct suture, 2651 (32.9%) by a flap (of which 44.8% were simple flaps), 42 (0.5%) by wedge excision and 111 (1.4%) by grafts. The CBR was 1.79, the BTR was 3.1 and the NNT was 28.6.


CONCLUSIONS
In this network of Australian skin cancer clinics, one in three biopsies identified a skin cancer (BTR, 3.1), and about 29 benign lesions were excised per melanoma (NNT, 28.6). The estimated NNT was similar to that reported previously in general practice. More data are needed on health outcomes, including effectiveness of treatment and surgical repair.
School of Medicine, University of Queensland, Herston, QLD, Australia.
David
D
Wilkinson
Deborah A
DA
Askew
Anthony
A
Dixon
D001315:Australia; D001706:Biopsy; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017679:Cryotherapy; D003475:Curettage; D003625:Data Collection; D006801:Humans; D006278:Medicare; D008545:Melanoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D009506:Nevus / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D016526:Workload