Abstract
The cost effectiveness of general practitioners undertaking minor surgery in their practices was determined in a prospective comparison of patients having minor surgery undertaken in five general practices over a 12 week period in 1989, and in the departments of dermatology and general surgery in Rotherham District General Hospital over a contemporaneous eight week period. There were no differences between the settings in the reported rates of wound infection or other complications and only one general practice patient was subsequently referred to hospital for specialist treatment. General practitioners sent a smaller proportion of specimens to a histopathology laboratory than hospital doctors (61% versus 90%, P less than 0.001); incorrectly diagnosed a larger proportion of malignant conditions as benign (10% versus 1%, P less than 0.05) and inadequately excised 5% of lesions where this never happened in hospital (difference not significant). General practice patients had shorter waiting times between referral and treatment, spent less time and money attending for treatment and more of them were satisfied with their treatment. The cost of a procedure undertaken in general practice was less than in hospital--pounds 33.53 versus pounds 45.54 for the excision of a lesion and pounds 3.00 versus pounds 3.22 for cryotherapy of a wart (1989-90 prices). Performing minor surgery in general practice would seem cost effective compared with a hospital setting. However, the risk of general practitioners inadequately excising a malignancy and not sending it to a histopathology laboratory must be addressed and the conclusion regarding cost effectiveness only applies where general practice is a substitute for the hospital setting and not an additional activity.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brown J. S. Minor operations in general practice. Br Med J. 1979 Jun 16;1(6178):1609–1610. doi: 10.1136/bmj.1.6178.1609. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jacob A., Jacyna M. R. Minor surgery in general practice. J R Coll Gen Pract. 1986 Jun;36(287):292–292. [PMC free article] [PubMed] [Google Scholar]
- Paraskevopoulos J. A., Hosking S. W., Johnson A. G. Do all minor excised lesions require histological examination? Discussion paper. J R Soc Med. 1988 Oct;81(10):583–584. doi: 10.1177/014107688808101010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wall D. W. A review of minor surgery in general practice in the United Kingdom. Fam Pract. 1987 Dec;4(4):322–329. doi: 10.1093/fampra/4.4.322. [DOI] [PubMed] [Google Scholar]