Structure, quality and accessibility of the Dutch acne healthcare; a care providers’ perspective

Abstract

Background Despite the wide range of available treatment modalities a delay between the first outbreak of acne vulgaris and an effective treatment outcome is experienced by many patients. Considering the growing incentives to improve patient satisfaction and quality of care while reducing healthcare costs, insights into the structure, quality and accessibility of acne healthcare services beyond guidelines are therefore needed. Objective To provide insights into the structure, quality and accessibility of acne healthcare services. Methods A qualitative study was conducted according to the principles of 'situational analysis'. The Dutch acne healthcare system was taken as an illustrative example. Twenty-four semi-structured interviews were conducted among representatives of the 4 main Dutch professions providing acne care. All interviews were audiotaped, transcribed verbatim and analysed. Results Multiple facilitators and barriers emerged from the interviews. Identified facilitators were care providers delivering personalized patient care and having a positive attitude towards formalised multidisciplinary care delivery. A lack of streamlined referral pathways and standardisation in acne severity-assessment, financial aspects and unfamiliarity with the content and added value of other acne care professionals were identified as barriers. Further research is recommended to investigate how demedicalisation, the gatekeepers role, and the impact of location and work setting influence the quality of and accessibility to care. Conclusions Identified facilitators and barriers and an overall positive attitude of care providers towards multidisciplinary care provision provides opportunities for the utilisation of future guidelines involving streamlined referral pathways and good working arrangements between all acne care providing professions.

Publication Trends of Qualitative Research in Dermatology

“…Figure 1 shows the PRISMA flow diagram of the selection criteria. A total of 1398 studies were screened, and 249 studies (17.8%) were ultimately included in the database …”

Reallocations in acne healthcare: exploring the possible roles and added value of non-physicians by a mixed-methods study design

“…Dermatological healthcare services, such as the acne care provision, are well suited for exploring the opportunities for care reallocation as many types of care professionals are involved in the care process. In the Netherlands, acne care is mainly delivered by general practitioners and dermatologists, who provide several (primarily pharmacological) treatment modalities [6][7][8][9]. The Dutch healthcare system also recognizes nonphysician care providers, among which dermal therapists [10] and beauticians are the most common professions (characteristics of both non-physician professions can be found in Table 1).…”

“…In the real-life clinical practice, this is expressed by the unfamiliarity of care providers of different organizational levels with the content and added value of each other's roles in addressing to acne reduction. This often causes a delay in referring patients towards other disciplines, which increases the risk of unnecessary costs and the chance of developing psychological problems or lifelong scars [6]. In order to reallocate tasks between physicians and non-physicians shifts within the organization of the acne healthcare are required.…”