Medical Care
Volume 54, Issue 10, 2016, Pages 921-928

Second medical opinion: Utilization rates and characteristics of seekers in a general population (Article)

Shmueli L.* , Shmueli E. , Pliskin J.S. , Balicer R.D. , Davidovitch N. , Hekselman I. , Greenfield G.
  • a Department of Health Systems Management, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, 84105, Israel
  • b Department of Industrial Engineering, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
  • c Department of Health Systems Management, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, 84105, Israel, Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
  • d Clalit Research Institute, Clalit Health Services, Tel Aviv, Israel
  • e Department of Health Systems Management, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, 84105, Israel
  • f Clalit Mushlam Health Insurance, Clalit Health Services, Bnei Brak, Israel
  • g Department of Health Systems Management, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, 84105, Israel, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom

Abstract

Background: Second opinion (SO) is common in medical practice and can reduce unnecessary risks and costs. To date, there is no population-based estimation of how many people seek SOs and what the characteristics of second-opinion seekers are. Objectives: To estimate how many people seek SOs, and what the characteristics of second-opinion seekers are. Methods: We conducted both a medical records analysis (n = 1,392,907) and a cross-sectional national telephone survey with a representative sample of the general Israeli population (n = 848, response rate = 62%). In the medical records analysis, we linked consultations with specialists at community secondary care and private consultations using claims data. We developed a time-sensitive algorithm that identified potential SO instances. In both methods, we predicted the characteristics of second-opinion seekers using multivariate logistic regressions. Results: The medical records analysis and the survey findings were highly consistent, and showed that about sixth (14.9% in the medical records vs. 17.2% in the survey) of a general population sought a SO, mostly from orthopedic surgeons. Women, native-born, and established immigrants, people living in central urban areas or close to central urban areas, people with chronic conditions, and those who perceived their health status as not very good, were more likely to seek SOs than others. Conclusions: A considerable amount of people sought a SO. Certain patient profiles tended to seek SOs more than others. Such utilization patterns are important to devise policy regarding SOs, due to their implications on expenditure, policy, clinical outcomes, and patient satisfaction. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Author Keywords

Second opinion health policy Utilization

Index Keywords

urban area immigrant Israel indigenous people human Israeli middle aged statistics and numerical data priority journal health status private practice chronic disease algorithm Algorithms Cross-Sectional Studies Surveys and Questionnaires Young Adult cross-sectional study Humans Adolescent consultation male female patient referral risk factor Risk Factors medical record Referral and Consultation telephone interview questionnaire Article health care utilization major clinical study adult utilization secondary health care second opinion orthopedic surgeon attitude to health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84969792729&doi=10.1097%2fMLR.0000000000000567&partnerID=40&md5=6a64f652cc8cb3086fac2125b090b949
DOI: 10.1097/MLR.0000000000000567
ISSN: 00257079
Cited by: 11
Original Language: English