Effects of a medical second opinion programme on patients’ decision for or against knee arthroplasty and their satisfaction with the programme

Autor: Martin Weigl, Jens Pietzner, Rebecca Kisch, Alexander Paulus, Volkmar Jansson, Eva Grill
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-12 (2021)
Druh dokumentu: article
ISSN: 1471-2474
DOI: 10.1186/s12891-021-04465-5
Popis: Abstract Background German social legislation gives patients the right to obtain a second opinion before elective surgery and defines quality criteria for reimbursement by statutory health insurances. However, the effects of second opinions before elective surgery are largely unknown. The aim of this study was to evaluate the effects of a second opinion programme in patients recommended for knee arthroplasty. Methods The largest statutory health insurance funds in Bavaria offered patients who had been recommended to have knee arthroplasty the opportunity to partake in a second opinion programme which consisted of an in person presentation to an experienced knee surgeon. In this cohort study, consecutive patients from this second opinion programme who signed informed consent were included from 07/10/2016 to 14/02/2020. Data were collected before and after the second opinion visit. Results A total of 141 (66%) of 215 patients who presented for a second opinion participated in the evaluation study. The second opinion physician recommended knee arthroplasty to 40% of the patients, later knee arthroplasty if the conditions worsened to 40%, and no knee arthroplasty to 20%. After receiving the second opinion 28 of 56 (41%) undecided patients preferred knee arthroplasty, 14 no knee arthroplasty, 14 remained undecided. Four of 46 patients with a preference for “arthroplasty” changed their decision to “no arthroplasty”, five of 35 patients from “no arthroplasty” to “arthroplasty”. The patients were more confident in their decision according to the decision confidence scale (before: 5.4 ± 3.0; after: 7.8 ± 2.5; p
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