The efficacy of second-opinion consultation programs: a cost-benefit perspective

Area of Science:

• Health Services Research
• Medical Economics

Background:

• A large Taft-Hartley welfare fund provided medical coverage for 120,000 beneficiaries.
• Elective surgical procedures often involve recommendations from initial physicians.

Purpose of the Study:

• To evaluate the cost-effectiveness of a mandatory second-opinion consultation program.
• To determine program savings and benefit-cost ratio.

Main Methods:

• A cohort of 342 individuals who received non-confirmation for surgery was analyzed.
• A control group with positive confirmation was randomly selected for comparison.
• Both groups were followed for one year post-consultation.

Main Results:

• Total program savings were estimated at $534,791.
• Medical care utilization savings amounted to $361,756, and productivity savings were $173,035.
• The program cost $203,300, yielding a benefit-cost ratio of 2.63.

Conclusions:

• Mandatory second-opinion consultation programs are consumer-oriented and cost-effective.
• Intervention before care is rendered in such programs demonstrates clear economic benefits.