Second Opinions before Surgery Have the Potential to Reduce Costs – An Exploratory Analysis

Abstract

Aim In this study cost data of patientʼs first and second opinion of a German second opinion program of patients with orthopedic indications are raised and compared. Methods Anonymized patient data were used from a second opinion program gathered in the period from 2013 to 2015. Costs of the first and second opinion were raised using DRG, the EBM catalog, the remuneration agreement on physical therapy and the price of drugs. In order to increase transferability, initial therapy recommendation and second opinion were compared in a cost analysis to determine a theoretical savings potential. Results A total of 170 consecutive patients with orthopedic indication and first and second opinion were analyzed in this study. Only one out of three initial therapy recommendations was confirmed by the second opinion. In the second opinion, physiotherapy and pain therapy were often suggested for indications which received a surgery referral by the initial therapy recommendation. In scenario 1 (average resource use), the costs of the first therapy recommendation in median was 5020.96 € (IQR = 961.71 – 7342.66), the second opinion was 322.07 € (IQR = 146.39 – 1341.32). In median, the operation costs of the initial therapy recommendation were equal to 156.12 physiotherapeutic sessions and 26.02 N3 packs Ibuprofen 800. Conclusion Therapy costs for the initial therapy recommendation are clearly exceeding the therapy costs of the second opinion. This assumes a potential to reduce therapy costs with the use of a second opinion. This study lays the foundation to carry out further conclusive analyses concerning this matter.

Second opinion and time to knee arthroplasty: a prospective cohort study of 142 patients

“…Another second opinion programme with no direct contact between the specialist and the patient reviewed the effect of second opinions. Their findings suggest second opinions lead to more conservative treatment recommendations and thus have the potential to reduce the healthcare costs 10. Patients in previous studies have reported that second medical opinions exert a significant influence on their treatment decisions 8 11 12.…”

“…Their findings suggest second opinions lead to more conservative treatment recommendations and thus have the potential to reduce the healthcare costs. 10 Patients in previous studies have reported that second medical opinions exert a significant influence on their treatment decisions. 8 11 12 However, to the best of our knowledge, no previous study has investigated the contribution of the second opinion recommendation to patients’ decision to undergo KA at 1 year after consultation.…”