Dermatologic care of institutionalized elderly patients: a survey among dermatologists in the Netherlands.

BACKGROUND

dermatologists are expected to be increasingly confronted with institutionalized elderly patients, due to the rapidly ageing world population.

OBJECTIVES

to determine the proportion of dermatologists visiting patients in nursing homes, together with the reasons for consultation, barriers to perform these visits and diagnostic and treatment patterns.

MATERIALS &

METHODS

a web-based questionnaire regarding dermatologic care in nursing home patients was developed by a multidisciplinary group of dermatologists, residents and elderly care physicians. A cover letter containing a link to the final questionnaire was sent by e-mail to all 661 dermatologists and dermatology residents in the Netherlands.

RESULTS

a total of 130 eligible questionnaires were returned (19.7%). Most respondents (79.2%) never had contact with an elderly care physician concerning a nursing home patient. However, only 30.0% of the respondents ever visited a patient within a nursing home. The most common reasons for nursing home visits were cutaneous (pre)malignancies (51.4%), eczema/dermatitis (25.7%) and (pressure) ulcers (8.6%). The most important barriers mentioned to perform nursing home visits were a lack of time and indistinct and/or inadequate financial compensation. Diagnostic and treatment patterns often differed from the outpatient clinic due to various patient-related and logistic factors.

CONCLUSION

dermatologists are frequently confronted with nursing home patients but only a minority visits patients within nursing homes. Lack of time and/or financial compensation seem important barriers.