Abstract：
BACKGROUND:As of 2015, second opinions are legally implemented in Germany. However, empirical results from German second opinion programs are lacking. The aim of this study was to examine several aspects within a population of a German second opinion program. METHODS:Study population consisted of patients who sought a second opinion in the period from August 2011 to December 2016. Multivariate logistic regression and ANOVA were used to examine differences in patient characteristics, differentiated by agreement of initial therapy recommendation and second opinion. Follow-up points for patient satisfaction and HRQoL were defined at 1, 3 and 6 months after obtaining the second opinion. RESULTS:Total number of patients who sought a second opinion was 1414. Most common indications concerned the knee (37.3%), spine (27.3%), hip (11.5%) and shoulder (10.1%). The independent specialists did not confirm the initial therapy recommendations in two out of three cases. The type of indication influenced the agreement between initial therapy recommendation and the second opinion significantly (p = 0.035). The second opinion and the offered service was highly valued by the patients (89%). CONCLUSIONS:The second opinion offers patients the possibility to confirm a medical indication independently and support patients in their decision making process. Reasons for the large discrepancy between initial therapy recommendation and second opinion should be addressed in future research.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Weyerstraß J,Prediger B,Neugebauer E,Pieper Ddoi
10.1186/s12913-020-5060-7subject
Has Abstractpub_date
2020-03-20 00:00:00pages
237issue
1issn
1472-6963pii
10.1186/s12913-020-5060-7journal_volume
20pub_type
杂志文章abstract：BACKGROUND:Proton pump inhibitors (PPIs) remain one of the world's most frequently prescribed medications and there is a growing number of publications on correct versus incorrect use of PPIs worldwide. The objective of this observational retrospective study was to assess changes in PPI prescribing trends over the past...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-018-3358-5
更新日期：2018-07-11 00:00:00
abstract：BACKGROUND:Environmental impact assessments of pharmaceuticals typically consider only a part of the pharmaceutical supply chain, e.g. tablet formulation. While the environmental impact can be expressed in environmental Human Health burden due to resource use and emissions, the Human Health benefit of the pharmaceutica...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-019-4247-2
更新日期：2019-06-19 00:00:00
abstract：BACKGROUND:The number of type 2 diabetes mellitus (T2DM) patients and related treatment costs are rapidly increasing. Consequentially, more cost-effective and efficient strategies for the treatment of T2DM are needed. One such strategy is improving patients' self-management. As patients are more and more expected to se...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-019-4384-7
更新日期：2019-08-28 00:00:00
abstract：BACKGROUND:To discriminatively evaluate the cost-saving effects of a disease management program for diabetic nephropathy patients through care process rectification and, subsequently, improved health outcomes. METHODS:This study links public medical insurance claims data to the health records of a disease management p...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-020-05297-0
更新日期：2020-05-11 00:00:00
abstract：BACKGROUND:Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered i...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-018-3120-z
更新日期：2018-05-02 00:00:00
abstract：BACKGROUND:The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Recently, there has been increasing attention paid to responsiveness in evaluating the performance of a healthcare system in a variety of service set...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-1980-2
更新日期：2017-01-13 00:00:00
abstract：BACKGROUND:All countries face challenging decisions about healthcare coverage. Malawi has committed to achieving Universal Health Coverage (UHC) by 2030, the timeframe set out by the Sustainable Development Goals (SDGs). As in other low income countries, scarce resources stand in the way of more equitable health access...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-020-06002-x
更新日期：2020-12-14 00:00:00
abstract：BACKGROUND:The General Medical Services primary care contract for the United Kingdom financially rewards performance in 19 clinical areas, through the Quality and Outcomes Framework. Little is known about how best to determine the size of financial incentives in pay for performance schemes. Our aim was to test the hypo...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-12-94
更新日期：2012-04-16 00:00:00
abstract：BACKGROUND:General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such fact...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-3-8
更新日期：2003-03-24 00:00:00
abstract：BACKGROUND:Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of dis...
journal_title：BMC health services research
pub_type： 杂志文章,评审
doi：10.1186/s12913-016-1363-0
更新日期：2016-04-06 00:00:00
abstract：BACKGROUND:Social accountability is defined as the responsibility of institutions to respond to the health priorities of a community. There is an international movement towards the education of health professionals who are accountable to communities. There is little evidence of how communities experience or articulate ...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-2239-7
更新日期：2017-04-12 00:00:00
abstract：BACKGROUND:This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals pl...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-14-464
更新日期：2014-10-15 00:00:00
abstract：BACKGROUND:Care coordination has increasingly been recognized as an important aspect of high-quality health care delivery. Robust measures of coordination processes will be essential tools to evaluate, guide and support efforts to understand and improve coordination, yet little agreement exists among stakeholders about...
journal_title：BMC health services research
pub_type： 杂志文章,评审
doi：10.1186/1472-6963-13-119
更新日期：2013-03-28 00:00:00
abstract：BACKGROUND:Ethiopia has been deploying specially trained new cadres of community based health workers in urban areas of the country known as urban health extension professionals since 2009. At present, relatively little work has focused on understanding to what extent this new program is accepted and used by the commun...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-2129-z
更新日期：2017-03-14 00:00:00
abstract：BACKGROUND:Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remo...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-12-70
更新日期：2012-03-21 00:00:00
abstract：BACKGROUND:Antimicrobial resistance (AMR) is a prominent threat to public health. Although many guidelines have been developed over the years to tackle this issue, their impact on health care practice varies. Guidelines are often based on evidence from clinical trials, but these have limitations, particularly in the br...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-019-4787-5
更新日期：2019-12-05 00:00:00
abstract：BACKGROUND:The World Health Organisation has designed a pregnancy registry to investigate the effect of maternal drug use on pregnancy outcomes in resource-limited settings. In this sentinel surveillance system, detailed health and drug use data are prospectively collected from the first antenatal clinic visit until de...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-014-0525-1
更新日期：2014-10-31 00:00:00
abstract：BACKGROUND:Several previous studies conducted on cancer registry data and hospital discharge records (HDR) have found an association between hospital volume and the recourse to breast conserving surgery (BCS) for breast cancer. The aim of the current study is to depict concurrent time trends in the recourse to BCS and ...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-7-167
更新日期：2007-10-18 00:00:00
abstract：BACKGROUND:Family-centered care (FCC), based on collaborative participation of the family along with a team of health care providers, is found to increase the well-being of sick infants in neonatal critical care units. Over the last 4 years, the neonatal unit of Dr. Ram Manohar Lohia Hospital in Delhi has innovated and...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-019-4017-1
更新日期：2019-03-21 00:00:00
abstract：BACKGROUND:Medical devices and in vitro diagnostic tests (IVD) are vital components of health delivery systems but access to these important tools is often limited in Africa. The regulation of health commodities by National Regulatory Authorities is intended to ensure their safety and quality whilst ensuring timely acc...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-014-0524-2
更新日期：2014-10-31 00:00:00
abstract：BACKGROUND:The rapid HIV antibody test is the diagnostic tool of choice in low and middle-income countries. Previous evidence suggests that rapid HIV diagnostic tests may underperform in the field, failing to detect a substantial number of infections. A research study inadvertently discovered that a clinic rapid HIV te...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-10-73
更新日期：2010-03-22 00:00:00
abstract：BACKGROUND:Access to health care is a particular concern given the important role of poor access in perpetuating poverty and inequality. South Africa's apartheid history leaves large racial disparities in access despite post-apartheid health policy to increase the number of health facilities, even in remote rural areas...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-014-0541-1
更新日期：2014-11-04 00:00:00
abstract：BACKGROUND:Health care professionals (HCP) are known key elements of effective patient's counselling and education. For patients taking warfarin, education about the dose, side effects, and toxicity is clearly identified as a cornerstone of achieving improved health and quality of life. The study objective was to evalu...
journal_title：BMC health services research
pub_type： 杂志文章,多中心研究
doi：10.1186/s12913-018-2874-7
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:People experiencing homelessness and mental illness face multiple barriers to care. The goal of this study was to examine the association between health service use and indicators of need among individuals experiencing homelessness and mental illness in Vancouver, Canada. We hypothesized that those with more...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-14-404
更新日期：2014-09-18 00:00:00
abstract：BACKGROUND:In the United States (US), Medicaid capitated managed care costs are controlled by optimizing patients' healthcare utilization. Adults in capitated plans utilize primary care providers (PCP) more than emergency departments (ED), compared to fee-for-service (FFS). Pediatric data are lacking. We aim to determi...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-020-05409-w
更新日期：2020-06-12 00:00:00
abstract：BACKGROUND:Poor adherence is the main barrier to the effectiveness of HIV medication. The objective of this study was to explore and conceptualize patterns and difficulties in physicians' work with patients' adherence to HIV medication. No previous studies on this subject have directly observed physicians' behavior. M...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-6-154
更新日期：2006-12-04 00:00:00
abstract：BACKGROUND:Management, culture and systems for better quality and patient safety in hospitals have been widely studied in Norway. Nursing homes and home care, however have received much less attention. An increasing number of people need health services in nursing homes and at home, and the services are struggling with...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-020-05149-x
更新日期：2020-04-03 00:00:00
abstract：BACKGROUND:Measurement of healthcare spatial access over a network involves accounting for demand, supply, and network structure. Popular approaches are based on floating catchment areas; however the methods can overestimate demand over the network and fail to capture cascading effects across the system. METHODS:Optim...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-015-0919-8
更新日期：2015-07-17 00:00:00
abstract：BACKGROUND:Individuals with severe disability often require personal assistance and help from informal caregivers, in addition to conventional health care. The utilization of assistance dogs may decrease the need for health and social care and increase the independence of these individuals. Service and hearing dogs are...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-018-3014-0
更新日期：2018-06-27 00:00:00
abstract：BACKGROUND:Healthcare providers operate in a unique industry characterized by pursuit of perhaps the most noble of missions: the delivery of vital health and medical services to those in need. Distinguishing features abound, differentiating the healthcare industry from others, with such facets having the potential to c...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-2342-9
更新日期：2017-07-11 00:00:00
