[Compilation of Second Opinion Programs in the German Statutory Health Insurance].

OBJECTIVE: According to a new legislation passed in 2016, patients with an indication for elective procedures have the right to obtain a second opinion. The Federal Joint Committee has not yet provided a list of indications that this legislation will cover. Independently of this, the statutory health insurances can, nonetheless, pay for a second opinion. The aim of this article is to give an overview of current second opinion programs delivered by the statutory health insurance schemes.
METHODS: Websites of all German statutory health insurance schemes (n=117) were searched for second opinion programs and their features in November 2016. All data was extracted by one person and verified by a second person.
RESULTS: In total, 78 second-opinion programs were identified. Half of all statutory health insurance schemes (50%, n=59) provide at least one second-opinion program. The majority of them was in the field of orthopedics (78%, n=61) and oncology (58%, n=45). Multiple replies were possible. In most cases, second-opinion programs were outsourced (58%; n=44), followed by forwarding patients to health service providers contracted with the statutory health insurance scheme (45% n=34). Only in 11% (n=8) was the second opinion delivered by staff of the statutory health insurance scheme. The second opinion was delivered based on submitted documents only (63%; n=48), direct patient-physician contact (43%; n=33), and contact by phone (14%; n=11). The delivery of the second opinion took 7 days in median, while the delivery based on submitted documents only (median 7) was faster than the delivery by direct-physician contact (median 14).
CONCLUSIONS: The majority of those living in Germany have the possibility to obtain a second opinion. However, second-opinion programs are very heterogeneous so that patients are confused about their rights to second opinion. © Georg Thieme Verlag KG Stuttgart · New York.