[Obtaining a Second Opinion in Germany: an Analysis of the Billing Data of the Health Insurer AOK Nordost].

IF 0.7 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Gesundheitswesen Pub Date : 2024-07-01 Epub Date: 2024-07-16 DOI:10.1055/a-2304-5361

Dunja Bruch, Olga Resch, Stephanie Sehlen, Barbara Prediger, Filip Schröter, Achim Franzen, Cecile Ronckers, Edmund Neugebauer, Susann May

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引用次数: 0

Abstract

Objectives: The aim of this billing data analysis was to examine the implementation of the second opinion directive in Germany and to investigate how often informing patients about their right to a second opinion (SO) and obtaining a SO are documented.

Methods: To examine the frequency of "informing about SO" and "obtaining an SO", insured patients who received an indication for tonsillectomy, tonsillotomy or hysterectomy in 2019 or 2020 were included, as well as insured patients who received an indication for shoulder arthroscopy in Q2-Q3 2020. Data were analyzed descriptively.

Results: During the study period, 5307 surgeries were reported for the above-mentioned indications. "Informing about SO" was documented for 121 patients with surgery and "obtaining an SO" was documented for 12 patients with surgery. The proportion of documented "informing about SO" compared to the number of surgeries was highest for tonsillectomy/tonsillotomy<18 years (4%) and lowest for shoulder arthroscopy (0.6%). In total, no patient was documented for both "informing about SO" and "obtaining an SO".

Conclusions: The present billing data analysis shows that information about the right to an SO according to the directive as well as the obtaining of such an SO has not yet been implemented in standard care as required by law.

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[在德国获得第二意见：对 AOK Nordost 医疗保险公司账单数据的分析]。

目的本账单数据分析旨在研究第二意见指令在德国的实施情况，并调查告知患者其有权获得第二意见（SO）和获得第二意见的记录频率：为了研究 "告知第二意见 "和 "获得第二意见 "的频率，研究对象包括在2019年或2020年获得扁桃体切除术、扁桃体切开术或子宫切除术指征的参保患者，以及在2020年第二季度至第三季度获得肩关节镜指征的参保患者。对数据进行了描述性分析：在研究期间，报告了 5307 例上述适应症的手术。121例手术患者记录了 "告知SO"，12例手术患者记录了 "获得SO"。与手术数量相比，扁桃体切除术/扁桃体切开术中记录 "告知《手术条例》"的比例最高：本账单数据分析显示，关于根据指令有权获得《手术申请表》的信息以及获得此类《手术申请表》的信息尚未按照法律要求在标准护理中实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gesundheitswesen PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

1.90

自引率

18.20%

发文量

308

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