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Minor surgery is better in secondary care, finds study

5 June 2008

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The quality of minor surgery carried out in general practice is not as high as that carried out in hospital, according to a study report in the latest Health Technology Assessment Journal.

The study measured the quality of dermatological procedures and ingrowing toenails by wound appearance and by satisfaction with the care and safety of surgery.

Wound appearance was significantly better in the hospital group as was the ability of the doctors to achieve complete excision of malignancies.

However, patients tended to be more satisfied with having the procedure in primary care, most likely due to convenience.

The mean cost of hospital-based minor surgery was £1,222.24, considerably higher than the £449.74 for primary care.

However, the authors point out that if postoperative complications are taken as an outcome (where both groups had similar results), both effectiveness and costs of alternative interventions are uncertain.

If, however, completeness of excision of malignancy is taken as an outcome, hospital minor surgery becomes more cost-effective.

The study concluded that minor surgery carried out in primary care is not safe, especially in terms of the ability of GPs to recognise malignant lesions and completeness of excision compared with hospital doctors.

Health Technology Assessment