Exploring spillover effects following surgical de-implementation: an observational evaluation of primary care, referrals, and time to surgical intervention following reductions in the use of tonsillectomy and Dupuytren’s contracture

Reductions in both surgical procedures were associated with small, but potentially important, changes to primary care utilisation and specialist treatment. Policy makers should identify potential spillovers from de-implementation, design policies to mitigate negative effects, and monitor these wider impacts alongside the direct influence on the targeted procedure rates.