Second opinion elective surgery programs: outcome status over time.

Given the increasing rate of surgery and the escalating costs of hospitalization, it seems appropriate to review the necessity of recommended elective surgery before the surgery is performed. The second opinion elective surgery program is designed to screen patients before they undergo surgery. Findings are based on all not confirmed for surgery cases and an equal number of confirmed for surgery cases who were evaluated one year after their second opinion consultation. Roughly 77.9% of those not confirmed had not had the surgery and, of this, 64.4% reported no medical treatment (potential surplus surgery). Of the 710 not confirmed cases, one third (34.9%) never reported receiving medical treatment. The majority of those individuals confirmed for surgery did have the operation; however, 25.4% had not had surgery one year from their consultation. Thirty-two per cent of the confirmed cases reported never receiving medical treatment. There were 77 individuals (11.1%) who were confirmed for surgery who neither reported having surgery nor any medical treatment (population at risk). Subsequent follow up studies will present a clearer assessment of the ability of the program to screen potential surplus surgery and to realize cost savings.