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

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.