Evidence map›Paper›PMID 39567968›Full record

ArticleBMC health services research2024

Integrating dermatologists in primary care: impact on delays, patient and professional experiences.

Maria Lovén, Amanda Eklund, Laura Huilaja, Markus Paananen, Paulus Torkki

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Maria LovénDepartment of Public Health, The University of Helsinki, Tukholmankatu 8, 00014, Helsingin yliopisto, Finland. maria.loven@helsinki.fi.ORCID http://orcid.org/0000-0003-4561-3831
Amanda EklundDepartment Industrial Engineering and Management, The Aalto University, Aalto, P.O. Box 11000, 00076, Espoo, Finland.ORCID http://orcid.org/0009-0007-2457-733X
Laura HuilajaDepartment of Dermatology and Medical Research Center, Oulu University Hospital, Kajaanintie 50, 90220, Oulu, Finland.ORCID http://orcid.org/0000-0002-7597-4323
Markus PaananenThe University of Oulu, Aapistie 5a, 90220, Oulu, Finland.ORCID http://orcid.org/0009-0006-3546-7657
Paulus TorkkiDepartment of Public Health, The University of Helsinki, Tukholmankatu 8, 00014, Helsingin Yliopisto, Finland.ORCID http://orcid.org/0000-0002-1127-4205

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrimary healthcare centres are burdened by the management of patients with skin conditions, while general practitioners might lack the expertise to assess skin changes accurately. The traditional care chain for skin findings is a multistage process that can cause delayed diagnosis and treatment, distressing the patient. This study aimed to determine whether adding a dermatologist to the primary care team would streamline the care pathway of patients with skin conditions, while examining levels of satisfaction among patients and healthcare professionals.

methodsA quasi-experimental multicentre study was conducted in three primary health centres in Finland. A dermatologist was integrated into two of the centres (intervention) but not the third (control). Data on timing of diagnosis and treatment and number of contacts were collected from records and analysed per care path. The Patient Enablement Instrument (PEI) and Net Promoter Score (NPS) were used to measure the patient's experience of the appointment. NPS and professional satisfaction queries were used to measure professional satisfaction.

resultsIn total 186 intervention and 176 control patients were included, with 38 primary care professionals. Compared with the control group, the intervention group showed a significantly shorter time to confirmed diagnosis and to treatment start (25 vs. 49 days, p < 0.001), with a higher proportion (49% vs. 27%, p < 0.001) receiving immediate treatment in the primary care setting. Patients in the intervention group required fewer visits. Patient experience by PEI and NPS scores were higher in the intervention group (p ≤ 0.022 for each). Satisfaction levels among professionals in both groups were higher after the intervention than before, although the NPS score did not improve significantly in the control group. Almost all professionals advocated for the continuation of the integrated care pathway.

conclusionsThe integration of dermatologists into the primary care streamlined the management of skin conditions from diagnosis to treatment, while improving the experiences of both patients and healthcare professionals. This integrated care path is beneficial for the management of patients with skin findings in primary care.

Indexed as

Patient SatisfactionPrimary Health CareAdultAgedAttitude of Health PersonnelDelayed DiagnosisDermatologistsFemaleFinlandHumansMaleMiddle AgedSkin DiseasesDelayDermatologistsGeneral practiceHealth personnelIntegrated health care systemsPatient experiencePEIPREMPrimary healthcareProfessional satisfaction

Identifiers

PMID39567968
PMCPMC11577956

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.