Aspects of minor surgery in general practice
Aspects of minor surgery in general practice
The context for this study was evaluation of a change that had been made to the GP contract in 1990, introducing a fee for service element to encourage them to provide a range of minor surgery procedures to their patients. This study evaluates some aspects of the provision of minor surgery by GPs that resulted.
The study included a randomised controlled equivalence trial whose objective was to test whether GPs were equal to hospital doctors at performing the procedures. Patients were randomised on presentation to their GP between treatment within the practice and treatment at the local hospital. Evaluation was by assessment of clinical quality of outcome, supplemented by examination of patient satisfaction and cost-effectiveness. This thesis concentrates on the clinical trial, but includes results from the satisfaction and cost-effectiveness studies performed by others. It also reports supporting data and questionnaire studies.
The trial shows that hospital doctors are better at performing minor operations, using cosmesis as the primary outcome. Patients are satisfied in both contexts, but more satisfied if their procedure is performed in primary care. At a marginal level, hospital care is less expensive for extra procedures, but is likely to be more expensive in total from the health service perspective, and more expensive for an individual patient.
The examination of data regarding GP minor surgery shows that there has been a shift away from more complex and expensive to perform procedures towards cheaper and easier procedures over the duration of the fee for service payment schedule. The questionnaire data shows that there are marked variations in a GPs likelihood of performing minor operations, the influences appear to include the GPs gender, their training and the in-hospital posts that they undertook prior to becoming a GP.
University of Southampton
Pockney, Peter Graham
9cbe4573-8ccb-4f70-88ec-f0a2398d9dfe
2004
Pockney, Peter Graham
9cbe4573-8ccb-4f70-88ec-f0a2398d9dfe
Pockney, Peter Graham
(2004)
Aspects of minor surgery in general practice.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
The context for this study was evaluation of a change that had been made to the GP contract in 1990, introducing a fee for service element to encourage them to provide a range of minor surgery procedures to their patients. This study evaluates some aspects of the provision of minor surgery by GPs that resulted.
The study included a randomised controlled equivalence trial whose objective was to test whether GPs were equal to hospital doctors at performing the procedures. Patients were randomised on presentation to their GP between treatment within the practice and treatment at the local hospital. Evaluation was by assessment of clinical quality of outcome, supplemented by examination of patient satisfaction and cost-effectiveness. This thesis concentrates on the clinical trial, but includes results from the satisfaction and cost-effectiveness studies performed by others. It also reports supporting data and questionnaire studies.
The trial shows that hospital doctors are better at performing minor operations, using cosmesis as the primary outcome. Patients are satisfied in both contexts, but more satisfied if their procedure is performed in primary care. At a marginal level, hospital care is less expensive for extra procedures, but is likely to be more expensive in total from the health service perspective, and more expensive for an individual patient.
The examination of data regarding GP minor surgery shows that there has been a shift away from more complex and expensive to perform procedures towards cheaper and easier procedures over the duration of the fee for service payment schedule. The questionnaire data shows that there are marked variations in a GPs likelihood of performing minor operations, the influences appear to include the GPs gender, their training and the in-hospital posts that they undertook prior to becoming a GP.
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Published date: 2004
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Local EPrints ID: 465382
URI: http://eprints.soton.ac.uk/id/eprint/465382
PURE UUID: 58ef1d41-b452-4037-ad1e-2555f5ae43d9
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Date deposited: 05 Jul 2022 00:41
Last modified: 16 Mar 2024 20:08
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Author:
Peter Graham Pockney
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