Table 1 Main results

Indications for which SecOPs are provided

(%, n/number of health insurers with SecOPs)^a

Orthopedics (75%, 21/28)

Oncology (71%, 20/28)

Cardiology (11%, 3/28)

Gynecology (11%, 3/28)

Pediatrics (11%, 3/28)

Urology (11%, 3/28)

Dermatology (7%, 2/28)

Ear, nose, and throat (7%, 2/28)

Gastroenterology (7%, 2/28)

General and visceral surgery (7%, 2/28)

Ophthalmology (7%, 2/28)

Other (18%, 5/28)

No restriction (21%, 6/28)

Method of ensuring independence of financial interests

(%, n/number of SecOPs)^a

Second opinion providers prohibited from

- conducting the subsequent procedure (66%, 29/44)

- working for the same company as the first opinion provider (57%, 25/44)

Other (20%, 9/44)

Delivery route^c

(%, n/number of SecOPs)^b

Outsourcing to an external service provider (45%, 20/44)

Contracts with selected health service provider (32%, 14/44)

Other (9%, 4/44), e.g. specific university hospitals

No (valid) answer (14%, 6/44)

Basis for second opinion

(%; n/number of SecOPs)^b

Submitted documents only (48%, 21/44)

Direct contact between patient and doctor (45%, 20/44)

Contact by phone (2%, 1/44)

No (valid) answer (5%, 2/44)

Conduct of evaluation of SecOPs (past or currently)

(%; n/number of SecOPs)^b

Yes (27%, 12/44)

No (50%, 22/44)

No (valid) answer (23%, 10/44)

Conduct of evaluations in the following 2 years? (%, n/number of SecOPs without evaluations)^b

Yes (45%, 10/22)

No (45%, 10/22)

No (valid) answer (9%, 2/22)

Insured persons obtaining SecOPs

median per year, iqr (n SecOPs)

31, 7–85 (26)

Time to delivery of second opinion

median, IQR (n SecOPs)

9 days, 5–15 (23)