[Analysis of the reasons for consultation and dermatology care cost in a primary care site].
BACKGROUND
The objective of the study was to the visits for esthetic reasons in an out-patient dermatology consultation and their cost and calculate the invoicing of these visits for a site other than the medical specialist consulted.


METHODS
Prospective study in an out-patient dermatology clinic for 12 random days in February 2005. Endpoints of age, gender, diagnosis, cost per visit, cryotherapy and electrocoagulation were collected. Patients were divided into 3 groups: request for esthetic treatment (A), request for dermatology visit (B) and did not come (C).


RESULTS
Group B was the largest, with 205 users (46 %), followed by C with 134/455 (29 %) and by A with 116/455 (25 %). In the latter group, the diagnoses were: seborrheic keratosis 39/455 (9 %), acrocordons 21/455 (5 %), remaining diagnoses (intradermal melanocytic nevi, cherry angioma, solar lentigos): 56/116 (11 %). The cost of these visits was 2,528. 8 euros in the 12 days analyzed and treatment of a subgroup of 85 patients (18.75 %) with cryotherapy or electrocoagulation increased it up to 5,043.80 euros. Estimated cost for one year would be 82,950 euros. Calculation of the invoicing for a non-public supplier site to the National Health Service would be: 8769.60 euros/month and 97,875 euros/year. If we add the treatments described, we go from 28,403.40 euros/month to 317,113.80 euros/year.


CONCLUSIONS
These data and daily experience should make us think about the ethical consequences (do all the patients have to wait the same time?) as well as legal and collective ones (what type of dermatology do we want to specialize in?).
Macaya-Pascual
A
A
Servicio de Dermatología, Hospital Universitari de Bellvitge, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. macaya@comb.es
López-Canós
R
R
López-Piqueras
S
S
Gómez
S
S
D003365:Costs and Cost Analysis; D003880:Dermatology / Q000191:economics*; D004954:Esthetics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012017:Referral and Consultation