ArticleBMC health services research2011
Minor surgery in general practice and effects on referrals to hospital care: observational study.
Article in BMC health services research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Referral interventions from primary to specialist care: a systematic review of international evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Pooled it
- Trial
- Office-Based Minor Surgery: An Ever-Increasing Challenge Not Only for the Dutch General Practitioner.Family medicine · 2023Article
- Procedures performed by general practitioners and general internal medicine physicians - a comparison based on routine data from Northern Germany.BMC family practice · 2018Article
- Implementing and evaluating a primary care service for oral surgery: a case study.BMC health services research · 2018Article
- Differences in Rate of Complete Excision of Basal Cell Carcinoma by Dermatologists, Plastic Surgeons and General Practitioners: A Large Cross-Sectional Study.Dermatology (Basel, Switzerland) · 2018Article
- A cross sectional study of surgical training among United Kingdom general practitioners with specialist interests in surgery.BMJ open · 2015Article
- Skin lesions suspected of malignancy: an increasing burden on general practice.BMC family practice · 2014Article
- Study protocol: the Registrar Clinical Encounters in Training (ReCEnT) study.BMC family practice · 2012Article
- Sami-speaking municipalities and a control group's access to somatic specialist health care (SHC): a retrospective study on general practitioners' referrals.International journal of circumpolar health · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStrengthening primary care is the focus of many countries, as national healthcare systems with a strong primary care sector tend to have lower healthcare costs. However, it is unknown to what extent general practitioners (GPs) that perform more services generate fewer hospital referrals. The objective of this study was to examine the association between the number of surgical interventions and hospital referrals.
methodsData were derived from electronic medical records of 48 practices that participated in the Netherlands Information Network of General Practice (LINH) in 2006-2007. For each care-episode of benign neoplasm skin/nevus, sebaceous cyst or laceration/cut it was determined whether the patient was referred to a medical specialist and/or minor surgery was performed. Multilevel multinomial regression analyses were used to determine the relation between minor surgery and hospital referrals on the level of the GP-practice.
resultsReferral rates differed between diagnoses, with 1.0% of referrals for a laceration/cut, 8.2% for a sebaceous cyst and 10.2% for benign neoplasm skin/nevus. The GP practices performed minor surgery for a laceration/cut in 8.9% (SD:14.6) of the care-episodes, for a benign neoplasm skin/nevus in 27.4% (SD:14.4) of cases and for a sebaceous cyst in 26.4% (SD:13.8). GP practices that performed more minor surgery interventions had a lower referral rate for patients with a laceration/cut (-0.38; 95%CI:-0.60- -0.11) and those with a sebaceous cyst (-0.42; 95%CI:-0.63- -0.16), but not for people with benign neoplasm skin/nevus (-0.26; 95%CI:-0.51-0.03). However, the absolute difference in referral rate appeared to be relevant only for sebaceous cysts.
conclusionsThe effects of minor surgery vary between diagnoses. Minor surgery in general practice appears to be a substitute for specialist medical care only in relation to sebaceous cysts. Measures to stimulate minor surgery for sebaceous cysts may induce substitution.
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