Z Orthop Unfall 2021; 159(04): 406-411
DOI: 10.1055/a-1114-6615
Original Article/Originalarbeit

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

Article in several languages: English | deutsch
Jan Weyerstraß
1   Faculty of Health, School of Medicine, University Witten Herdecke Faculty of Health, Witten
Barbara Prediger
2   Faculty of Health, University Witten Herdecke, Institute for Research in Operative Medicine, Cologne
Edmund Neugebauer
3   Deanʼs Office, Medical College Brandenburg Theodor Fontane, Neuruppin
Dawid Pieper
4   Chair of Surgical Research, Institute for Research in Operative Medicine (IFOM), Cologne
› Author Affiliations


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.

Publication History

Article published online:
21 April 2020

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