Barr J K, Schachter M, Rosenberg S N, Factor-Litvak P, McGarvey M R, Leto L
New York Business Group on Health, New York City.
QRB Qual Rev Bull. 1990 Jan;16(1):25-32. doi: 10.1016/s0097-5990(16)30331-1.
Initial examination of the surgery experience of participants in a large employer-sponsored second opinion program revealed minimal savings in medical resource costs. But closer examination of relative savings for specific procedure categories showed that the greatest savings are for high-cost procedures: hysterectomy, prostatectomy, back surgery, and hip replacement. Furthermore, a nonconfirming second opinion does not dissuade patients from some procedures. Decisions about which procedures to include in a mandatory program should consider volume, costs, and effects of nonconfirmation, as well as the advantages of a mandatory second opinion for skeptical patients, or for patients for whom a controversial procedure has been recommended.
对一个大型雇主赞助的二次诊断项目参与者的手术经历进行初步检查后发现，医疗资源成本的节省微乎其微。但对特定手术类别相对节省情况的进一步检查表明，节省最多的是高成本手术：子宫切除术、前列腺切除术、背部手术和髋关节置换术。此外，不一致的二次诊断并不会阻止患者进行某些手术。在决定将哪些手术纳入强制项目时，应考虑手术量、成本、非确认的影响，以及强制二次诊断对持怀疑态度的患者或被推荐进行有争议手术的患者的益处。
