Go

[Seth]

well sorta but not really

A skimmer pulls out gunk that wish and other stuff produce. It takes out waste directly out of the water.
As for a refugium, waste is turned into nitrates and stuff like that. The plants or macroalgae will suck out nitrates and nutrients. So it takes out waste indirectly.

So which is more efficient? Can't really say. They kinda do different things.