A casemix study of patients seen within an urban Aboriginal Health Service dermatology clinic over a five‐year period

Abstract

This is the largest study of Aboriginal and Torres Strait Islander dermatologic presentations to an urban specialist clinic within a communitycontrolled health organisation. It adds to our understanding of Aboriginal and Torres Strait Islander dermatoepidemiology. Patient files were reviewed over the five-year audit period, with age, gender, Indigenous status, diagnosis, disease category, 'new' or 'review consultation' and 'did not attend' (DNA) data recorded. Our study shows that eczema and benign, pre-malignant or malignant neoplasms are the most common presentations for urban Aboriginal and Torres Strait Islander patients. Lupus erythematosus and cutaneous infections were less prominent in comparison to data from rural and remote populations. Overall, a broad casemix of dermatologic presentations was observed. Similar to other studies, adult male patients were under-represented. Most skin malignancies were diagnosed in this cohort; this, therefore, identifies a possible target for public health intervention. A high ratio of new to review patients is consistent with the clinic offering a consultation model of care facilitated by primary health-care providers' support within Aboriginal Community-Controlled Health Service. DNA rates in this study were lower than hospital outpatient rates in a comparative study and may be attributed to specialist dermatology care being offered in a more culturally sensitive environment. The dermatology clinic at the Victorian Aboriginal Health Services (VAHS) provides a good breadth of specialist dermatology care. The community health-care model could be replicated in centres elsewhere, including interstate, to help overcome barriers to specialist dermatology care experienced by Aboriginal and Torres Strait Islander populations. Additionally, this model improves trainee exposure and understanding of Aboriginal and Torres Strait Islander health.

Rheumatology specialist care delivered at the Southern QLD Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care

“…12 Analogous subspecialty programmes in other parts of the country have also demonstrated increased attendance rates. 18,19 The adjusted attendance rate in our cohort was higher than the historical control, with an odds ratio of attendance of 1.35. The result was not statistically significant, though this may be related to the relatively small sample size available within the confines of an observational study.…”

“…The CoE is predominantly a primary health service and reported a large growth in both the number and attendance rate amongst its population in the first 4 years after its establishment, as well as better engagement with other visiting subspecialties 12 . Analogous subspecialty programmes in other parts of the country have also demonstrated increased attendance rates 18,19 …”

Changing Trends of Cutaneous Lupus Erythematosus (CLE) in a Tertiary Care Hospital in Northern Odisha, India

“…As it is noteworthy that acute cutaneous LE typically presents in the third decade of life, subacute cutaneous lupus erythematosus (SCLE) occurs primarily in young to middle-aged women and CCLE occurs more frequently in women in their fourth and fifth decade of life as suggested by Ng et al (2000) and Fabbri et al (2003), our results were no different [ 19 - 20 ]. While most of the LE patients were found to be residing in rural areas as observed in studies conducted by Mowla et al (2022) and Williams et al (2021) [ 14 , 21 ]. CCLE was more prevalent in farmers and laborers possibly due to working under the outdoor sun.…”

“…al. (2022) andWilliams et al (2021) [14,21]. CCLE was more prevalent in farmers and laborers possibly due to working under the outdoor sun.…”

Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project

“…While little is known about the prevalence of acne in Aboriginal youth, a cross-sectional analysis of data from primary care reported a lower frequency of acne presentations by Aboriginal youth; suggesting either a lower incidence of acne or lower rates of Aboriginal youth seeking medical care for acne [64]. Further, among Australian studies profiling the case-mix of patients seen in various dermatology outpatient clinics, presentation for acne was uncommon in Aboriginal patients [21,22,65].…”