GP minor surgery cuts referrals for cysts

Practice-based minor surgery for sebaceous cysts can reduce the chance of referral to hospital, Dutch research shows.

Researchers led by Christel van Dijk at the Netherlands Institute for Health Services Research in Utrecht found patients were less likely to be referred to hospital for sebaceous cysts if their GP practice performed more minor surgery.

Encouraging GPs to perform more minor surgery would further reduce referral rates, they concluded.

Researchers examined data from 48 practices in the Netherlands including 14,203 patients. They analysed GPs’ decisions over referral or treatment for laceration/cut, sebaceous cyst or benign neoplasm skin/nevus to determine to what extent the amount of minor surgery offered in practice affected referral rates.

Practices offering more minor surgery were found to have lower rates of referral for sebaceous cysts. GPs who offered minor surgery for the condition referred just 2.2%, compared with 10.6% referral in practices who did not offer minor surgery.

There were minor, but insignificant, effects of surgery on the other conditions analysed. If an average general practice performed 5% more minor surgery interventions in cases of sebaceous cysts, this would lead to a lowering of the referral rate of 4.3%.

Researchers concluded: ‘Encouraging GPs to perform more minor surgery interventions for patients with sebaceous cysts has the potential to prevent specialist referrals and cost reduction.

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

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