RESUMEN
INTRODUCTION: 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. METHOD: 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?).
Asunto(s)
Dermatología/economía , Costos de la Atención en Salud , Costos y Análisis de Costo , Estética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atención Primaria de Salud , Estudios Prospectivos , Derivación y ConsultaRESUMEN
Introducción. El objetivo del presente estudio fue conocer las visitas por motivos estéticos en una consulta de dermatología ambulatoria y su coste y estimar la facturación que estas visitas supondrían a un centro proveedor diferente al Institut Català de la Salut (ICS). Método. Estudio prospectivo en una consulta de Dermatología ambulatoria durante 12 días aleatorios de febrero de 2005. Se recogieron variables de edad, sexo, diagnóstico, coste por visita, crioterapia y electrocoagulación. Se dividieron los pacientes en 3 grupos: demanda de tratamiento estético (A), demanda de visita dermatológica (B) y no acude (C). Resultados. El grupo B resultó el mayor, con 205 usuarios (46 %), seguido del C con 134/455 (29 %) y por el A con 116/455 (25 %). En este último grupo los diagnósticos fueron: queratosis seborreica 39/455 (9 %), acrocordones 21/455 (5 %), resto de diagnósticos (nevus melanocíticos intradérmicos, puntos rubí y lentigos solares) 56/116 (11 %). El coste de estas visitas fue de 2.528,8 euros en los 12 días analizados, y el tratamiento de un subgrupo de 85 pacientes (18,7 %) con crioterapia o electrocoagulación lo elevó hasta los 5.043,8 euros. El coste estimado para un año sería de 82.950 euros. La estimación de la facturación de un centro proveedor que no fuera de titularidad pública al Sistema Nacional de Salud (SNS) sería: 8.769,6 euros/mes y 97.875 euros/año. Si añadimos los tratamientos descritos, pasamos a 28.403,4 euros/mes y a 317.113,8 euros/año. Conclusiones. Estos datos y la experiencia diaria deben hacernos reflexionar sobre las consecuencias éticas (¿tienen que esperar todos los pacientes lo mismo?), jurídicas y colectivas (¿a qué tipo de dermatología queremos dedicarnos?)
Introduction. 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. Method. 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?)