- Second Opinions
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by Lifeline Spine
How a Second Opinion Can Save You Money and Improve Your Outcome
A study analyzing the cost-effectiveness of second opinions for spine surgery found that many patients can avoid unnecessary procedures while improving their quality of life. Researchers reviewed 1,088 patients who were initially told they needed surgery and found:
- 60.8% were recommended for conservative treatment instead of surgery.
- Only 34.7% still needed surgery after a second opinion.
- Complex spine surgeries (like spinal fusions) were necessary in only 3.7% of cases.
- Each patient saved an average of $6,705 in medical costs by following the second opinion recommendation.
- Patients had better quality of life outcomes compared to those who underwent the originally recommended surgery.
This study confirms that second opinions not only help prevent unnecessary surgeries but also reduce healthcare costs while improving patient satisfaction.
Cost-effectiveness of a second opinion program on spine surgeries: an economic analysis
Eliane Antonioli, Daniel Tavares Malheiro, Vanessa Damazio Teich, Isabela Dias Paião, Miguel Cendoroglo Neto, Mario Lenza
Abstract
Background. In this study we proposed a new strategy to measure cost-effectiveness of second opinion program on spine surgery, using as measure of effectiveness the minimal important change (MIC) in the quality of life reported by patients, including the satisfaction questionnaire regarding the treatment and direct medical costs.
Methods. Retrospective analysis of patients with prior indication for spine surgery included in a second opinion program during May 2011 to May 2019. Treatment costs and outcomes were compared considering each patients’ recommended treatment before and after the second opinion. Costs were measured under the perspective of the hospital, including hospital stay, surgical room, physician and staff fees and other costs related to hospitalization when surgery was performed and physiotherapy or injection costs when a conservative treatment was recommended. Reoperation costs were also included. For comparison analysis, we used data based on our clinical practice, using data from patients who underwent the same type of surgical procedure as recommended by the first referral. The measure of effectiveness was the percentage of patients who achieved the MIC in quality of life measured by the EQ-5D-3 L 2 years after starting treatment. An incremental cost-effectiveness ratio (ICER) was calculated.
Results. Based upon the assessment of 1,088 patients that completed the entire second opinion process, conservative management was recommended for 662 (60.8%) patients; 49 (4.5%) were recommended to injection and 377 (34.7%) to surgery. Complex spine surgery, as arthrodesis, was recommended by second opinion in only 3.7% of cases. The program resulted in financial savings of -$6,705 per patient associated with appropriate treatment indication, with an incremental effectiveness of 0.077 patients achieving MIC when compared to the first referral, resulting in an ICER of $-87,066 per additional patient achieving the MIC, ranging between $-273,016 and $-41,832.
Conclusions. After 2 years of treatment, the second opinion program demonstrated the potential for cost-offsets associated with improved quality of life..
