Access to plastics: assessing the need for plastic surgery services.

OBJECTIVE

To investigate the apparently poor access of one district's residents to plastic surgery services.

DESIGN

Retrospective study of age-standardised operation rates for the year 1991-92. Operation rates were taken as a proxy measure for access.

SETTING

Sunderland District Health Authority, and Durham District Health Authority.

MAIN OUTCOME MEASURES

Operation rates for surgical specialties in the two districts.

RESULT

There were considerable differences in the operation rates for plastic surgery between districts in the Region. Detailed analysis of two districts revealed a significant difference between the two (Sunderland 2.25/1,000; Durham 4.24/1,000, P < 0.001). Sixteen diagnoses were identified as contributing to this difference. However, when these diagnoses were examined across all surgical specialties, the difference in operation rates virtually disappeared (Sunderland 6/1,000; Durham 6.16/1,000).

CONCLUSION

Sunderland residents were far more likely to have 'plastic' cases treated by other than plastic surgery specialists, which reflects the balance and expertise of specialties in the district. The need for plastic surgery services will be affected by the local interest and expertise. Operation rates should not be used on their own to indicate inequity in access.