Can cancer patients seeking a second opinion get better care?

Am J Manag Care

No 17, Xu-Zhou Road, Taipei, Taiwan 100, Taiwan.

Published: May 2013

Objectives: To investigate whether cancer patients who sought a second opinion received better medical care.

Study Design: A total of 1358 newly diagnosed colorectal cancer patients undergoing resection were identified from Taiwan's National Health Insurance Research Database between 2004 and 2008. The frequency of doctor shopping and hospital shopping in the 6 months before resection was used to define "seeking a second opinion."

Methods: A generalized hierarchical linear model was used to determine the influence of doctor shopping and hospital shopping on in-hospital complications and prolonged hospitalization after colorectal resection.

Results: The risk of in-hospital complications for heavy doctor shoppers was significantly higher than that for patients who were not doctor shoppers (odds ratio [OR] = 1.675, P = .037). However, the risk was significantly lower for heavy hospital shoppers compared with those who were not hospital shoppers (OR = 0.272, P = .007). The frequency of doctor shopping and hospital shopping was not significantly associated with prolonged hospitalization.

Conclusions: For colorectal resection patients, the selection of a proper hospital for surgery resulted in better surgical care. The quality of surgical care was worse with heavy doctor shopping. We suggest that healthcare authorities disclose data about the quality of a hospital's cancer treatment to increase patient access to such information. This may help patients find quality healthcare providers more quickly and reduce the waste of medical resources resulting from the long process of seeking medical care.

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