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09-01-2011 | General practice | Article

GP minor skin surgery cuts referrals


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Offering minor skin surgery in general practices may reduce hospital referrals and lower costs, Dutch researchers report.

The team, led by Christel van Dijk from the Netherlands Institute for Health Services Research in Utrecht, found that patients were less likely to be referred to a specialist for treatment of a sebaceous cyst if their practice performed minor surgery.

The researchers studied data from 48 practices across The Netherlands to assess practice referral rates for the four most common diagnoses treatable by minor surgery, namely: laceration/cut; neoplasm skin benign/unspecified; nevus/mole; and sebaceous cyst.

They found that referral rates were lower for cases in which practice-based minor surgery was performed than for cases with no minor surgery. For sebaceous cysts the respective rates were 2.2% versus 10.6%.

"These results suggest that minor surgery indeed substituted for referrals," van Dijk and colleagues write in the journal BMC Health Services Research.

They further showed that the referral rate for sebaceous cysts correlated significantly with the amount of minor surgery performed at the practice: so GP practices that performed more minor surgery referred fewer patients to a medical specialist.

The team concludes: "Encouraging GPs to perform more minor surgery interventions for patients with sebaceous cysts has the potential to prevent specialist referrals and [for] cost reduction.

"Future research is required to explore the cost-effectiveness of minor surgery in detail."

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price