Ambulatory practice of dermatologists in Taiwan: A nationwide survey

Background: Skin diseases are among the most common public health problems and cause a significant burden. For policymakers and clinicians, comprehensive and detailed information is necessary to better allocate resources needed to care for skin diseases. This study was conducted to characterize the ambulatory practice of dermatologists in Taiwan. Methods: The study data were drawn from the datasets of Taiwan's National Health Insurance Research Database for 2013, with 623,614 records of ambulatory care visits representing 1/500 of all the claims in Taiwan for 2013. The analysis of these visits included the patient demographics, diagnoses, prescriptions, and procedures. Results: We identified 31,547 visits to dermatologic clinics, which accounted for 5.1% of all the ambulatory care visits in 2013. The three most commonly encountered diseases were contact dermatitis and other eczema, unspecified cause (34.3%, n = 10,811), acne (17.3%, n = 5452), and dermatophytosis (12.9%, n = 4065). Topical glucocorticoids (38.8%, n = 12,248), systemic antihistamines (35.4%, n = 11,172), and systemic antibiotics (15.2%, n = 4809) were the three most commonly prescribed drug categories. Clobetasol, a very potent glucocorticoid, was the most commonly prescribed medication (20.9%, n = 6579). In 22.9% of visits (n = 7248), combined glucocorticoid/antifungal preparations were prescribed. Conclusion: This study characterizes the current state of ambulatory dermatologic care in Taiwan. The results raise concerns about the misuse of very potent glucocorticoids and combined glucocorticoid/antifungal preparations in dermatologic practices. Copyright (C) 2018, the Chinese Medical Association. Published by Elsevier Taiwan LLC.