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1000 Titel
  • Analysis of second opinion programs provided by German statutory and private health insurance – a survey of statutory and private health insurers
1000 Autor/in
  1. Könsgen, Nadja |
  2. Prediger, Barbara |
  3. Bora, Ana-Mihaela |
  4. Glatt, Angelina |
  5. Hess, Simone |
  6. Weißflog, Victoria |
  7. Pieper, Dawid |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-03-09
1000 Erschienen in
1000 Quellenangabe
  • 21(1):209
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12913-021-06207-8 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941885/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Second medical opinions can give patients confidence when choosing among treatment options and help them understand their diagnosis. Health insurers in several countries, including Germany, offer formal second opinion programs (SecOPs). We systematically collected and analyzed information on German health insurers' approach to SecOPs, how the SecOPs are structured, and to what extent they are evaluated.!##!Methods!#!In April 2019, we sent a questionnaire by post to all German statutory (n = 109) and private health insurers (n = 52). In September 2019, we contacted the nonresponders by email. The results were analyzed descriptively. They are presented overall and grouped by type of insurance (statutory/private health insurer).!##!Results!#!Thirty one of One hundred sixty one health insurers (response rate 19%) agreed to participate. The participating insurers covered approximately 40% of the statutory and 34% of the private health insured people. A total of 44 SecOPs were identified with a median of 1 SecOP (interquartile range (IQR) 1-2) offered by a health insurer. SecOPs were in place mainly for orthopedic (21/28 insurers with SecOPs; 75%) and oncologic indications (20/28; 71%). Indications were chosen principally based on their potential impact on a patient (22/28; 79%). The key qualification criterion for second opinion providers was their expertise (30/44 SecOPs; 68%). Second opinions were usually provided based on submitted documents only (21/44; 48%) or on direct contact between a patient and a doctor (20/44; 45%). They were delivered after a median of 9 days (IQR 5-15). A median of 31 (IQR 7-85) insured persons per year used SecOPs. Only 12 of 44 SecOPs were confirmed to have conducted a formal evaluation process (27%) or, if not, plan such a process in the future (10/22; 45%).!##!Conclusion!#!Health insurers' SecOPs focus on orthopedic and oncologic indications and are based on submitted documents or on direct patient-physician contact. The formal evaluation of SecOPs needs to be expanded and the results should be published. This can allow the evaluation of the impact of SecOPs on insured persons' health status and satisfaction, as well as on the number of interventions performed. Our results should be interpreted with caution due to the low participation rate.
1000 Sacherschließung
lokal Health insurance
lokal Surveys and Questionnaires [MeSH]
lokal Informed decision making
lokal Humans [MeSH]
lokal Second opinion
lokal Second opinion programs
lokal Insurance, Health [MeSH]
lokal Germany [MeSH]
lokal Insurance Carriers [MeSH]
lokal Referral and Consultation [MeSH]
lokal Patient autonomy
lokal Research Article
lokal Survey
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  1. https://frl.publisso.de/adhoc/uri/S8O2bnNnZW4sIE5hZGph|https://frl.publisso.de/adhoc/uri/UHJlZGlnZXIsIEJhcmJhcmE=|https://frl.publisso.de/adhoc/uri/Qm9yYSwgQW5hLU1paGFlbGE=|https://frl.publisso.de/adhoc/uri/R2xhdHQsIEFuZ2VsaW5h|https://frl.publisso.de/adhoc/uri/SGVzcywgU2ltb25l|https://frl.publisso.de/adhoc/uri/V2Vpw59mbG9nLCBWaWN0b3JpYQ==|https://frl.publisso.de/adhoc/uri/UGllcGVyLCBEYXdpZA==
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