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

Area of Science:

• Health Economics
• Orthopedics
• Medical Decision Making

Background:

• Second opinion programs offer a valuable resource for patients seeking to validate initial medical recommendations.
• Orthopedic indications often involve complex treatment pathways with significant cost implications.

Purpose of the Study:

• To compare the costs associated with initial therapy recommendations versus second opinions for orthopedic patients in a German program.
• To determine the potential cost savings achievable through the utilization of second opinions.

Main Methods:

• Anonymized patient data from a German second opinion program (2013-2015) were analyzed.
• Costs were calculated using DRG, EBM catalog, physical therapy agreements, and drug prices.
• A comparative cost analysis was performed to assess theoretical savings.

Main Results:

• Only one in three initial orthopedic therapy recommendations were confirmed by a second opinion.
• Second opinions frequently recommended conservative treatments (physiotherapy, pain management) over surgery.
• Median costs for initial recommendations (5020.96€) significantly exceeded second opinions (322.07€).

Conclusions:

• Initial therapy recommendations for orthopedic conditions are substantially more expensive than second opinions.
• Implementing second opinion programs presents a significant potential for reducing healthcare therapy costs.
• Further research is warranted to solidify the financial and clinical impact of second opinions.