Localization of Second Opinion Physicians in Germany: Do Regional Differences Exist?

Aim of the study Since 2015, the right to obtain a second opinion has been anchored in the German Social Code Book V. This was specified in the framework of the Directive on the Second Opinion Procedure. Since 2019, insured persons of the statutory health insurance can obtain an independent-second opinion if they receive an indication for tonsillectomy/tonsillotomy (TE/TT) or hysterectomy (HE). Specialists meeting qualification criteria can apply to their Association of Statutory Health Insurance Physicians (AHIP) and then account for the second opinion. The AHIPs publish the addresses of the second opinion physician on their websites. The aim of this study was to present the spatial distribution of second opinions and to analyse regional differences. Methodology On 19.06.2020, all second opinion physicians were identified via the websites of the individual AHIPs. The corresponding addresses were downloaded and sorted by federal state and indication (TE/TT and HE). Accessibility maps were created to show the spatial distribution, mapping the distance from each potential residence to the nearest second opinion physician. Results A total of 253 and 407 second opinion physicians registered for TE/TT and HE, respectively. Looking at the total number of second opinion physicians for TE/TT and HE, there were 18 second opinion physicians per million inhabitants, the most in Saarl and, and the fewest in Bremen with one per million inhabitants. The travel time for a person to reach a second opinion physician also varied: In Hamburg, it took an average of 0.23 hours to reach the nearest second opinion physician for TE/TT and 0.25 hours for HE in Berlin. Patients from Rhineland-Palatinate (1.4 hours for HE) and Mecklenburg-Western Pomerania (1.2 hours for TE/TT) had the longest travel times.

Automated summary

This study aims to present the spatial distribution of second opinions and analyze regional differences in Germany's statutory health insurance system.