title: Health care utilization characteristics in patch test patients.
abstract: BACKGROUND
  The length of time between onset of symptoms and definitive diagnosis is associated with outcomes in contact dermatitis (CD). Understanding the health care experience of patients with CD could identify areas for improvement.
  
  
  OBJECTIVE
  The objective of the study was to describe the health care experience of individuals being patch tested and the barriers and facilitators to their seeking care.
  
  
  METHODS
  One hundred forty-nine patients completed a survey containing information on types of health care providers seen, length of wait times, and barriers and facilitators to seeking care.
  
  
  RESULTS
  Sixty-six percent were first assessed by their family physicians. Forty-five percent waited more than 3 months before seeing a health care provider. Common reasons for delay included thinking their symptoms (1) would get better, (2) were not serious enough, or (3) were not limiting their ability to work or carry out other activities. Most patients waited less than 3 months for dermatological assessment and for patch test consultation after referral.
  
  
  CONCLUSIONS
  Patients with possible CD spend considerable time in the health care system before they undergo definitive assessment. Understanding the reasons for not seeking care may be useful for promoting earlier evaluation and intervention to result in better outcomes.
authors.affiliation: From the *Faculty of Medicine, and †Department of Medicine and Dalla Lana School of Public Health, University of Toronto; ‡Department of Occupational and Environmental Health, and §Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Nurmohamed
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodley
authors.forename: Aaron
authors.initials: A
authors.lastname: Thompson
authors.forename: Dorothy Linn
authors.initials: DL
authors.lastname: Holness
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057210:Delayed Diagnosis; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D003876:Dermatitis, Atopic / Q000175:diagnosis*; D003877:Dermatitis, Contact / Q000175:diagnosis; D017453:Dermatitis, Irritant / Q000175:diagnosis*; D009783:Dermatitis, Occupational / Q000175:diagnosis*; D005194:Family Practice; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010328:Patch Tests; D010342:Patient Acceptance of Health Care; D013997:Time Factors; D014850:Waiting Lists; D055815:Young Adult