EuHEA Online Seminar - November 12: Second Opinions, Health Care Costs, and Outcomes in Elective Surgery

The next seminar in the EuHEA Online Seminar Series will take place on

Thursday, 12 November 2026, 1:30-2:30pm (CET)

Second Opinions, Health Care Costs, and Outcomes in Elective Surgery

Speaker: Yero Samuel Ndiaye, University of Cologne
Discussant: Luigi Siciliani, University of York
Chair: Katharina Blankart, Bern University of Applied Sciences

Abstract:

Objectives: We evaluate whether a structured second-opinion program that separates diagnosis from treatment can reduce potentially unnecessary elective surgery, health-care spending, and utilization without worsening patient outcomes. Methods: We link program records to administrative claims data from a large German statutory health insurer. The sample comprises patients receiving second opinions in orthopedics and neurosurgery between 2013 and 2019. We examine recommendation patterns and patient compliance and estimate outcomes using propensity-score matching combined with patient fixed-effects event-study and difference-in-differences models. Results: First and second opinions disagreed in 56% of cases, primarily when the first physician recommended surgery. Seventy percent of patients followed the second opinion. Compliance was associated with €431–478 lower monthly health-care expenditures, fewer physician visits and hospital days, and no deterioration in sick leave or labor-market outcomes. Savings were concentrated among patients advised against surgery and reflected avoided rather than delayed procedures. Discussion: Separating diagnosis from treatment can mitigate overtreatment and reduce spending without detectable adverse outcomes. Because program uptake remains low, expanding awareness may offer substantial savings.

Join the discussion in our Seminar Series by accessing the Zoom meeting here.

For details about the series, see https://euhea.eu/euhea-seminar-series-2026-2027.html.