Genetic testing costs and compliance with clinical best practices.
We sought to determine the costs of genetic testing and compliance with published guidelines and clinical best practices at our institution. A cost analysis was performed comparing the costs of ordered tests to the cost of the recommended testing. This was an approved quality improvement project at...
| Publicado en: | Journal of Genetic Counseling Vol. 29; no. 6; pp. 1186 - 1192 |
|---|---|
| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147379004&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147379004 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10597700 41A jtl: Journal of Genetic Counseling issn: 10597700 maglogo: N pubinfo: dt: Dec2020 vid: 29 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 147379004 147379004 147379004 10.1002/jgc4.1285 147379004 ppf: 1186 ppct: 6 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Genetic testing costs and compliance with clinical best practices. aug: au: Montanez, Kathleen Berninger, Taylor Willis, Mary Harding, Aaron Lutgendorf, Monica A. affil: Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego California sug: subj: Genetic Screening Economics Costs and Cost Analysis Quality Improvement Diagnostic Tests, Routine Human Academic Medical Centers California California Activated Protein C Resistance alpha-Thalassemia Hemochromatosis Record Review Practice Guidelines Cost Savings Cost Benefit Analysis Genetic Counseling ab: We sought to determine the costs of genetic testing and compliance with published guidelines and clinical best practices at our institution. A cost analysis was performed comparing the costs of ordered tests to the cost of the recommended testing. This was an approved quality improvement project at a tertiary teaching hospital in California. We identified charts associated with the genetic testing billing codes for common genetic tests through our contracted laboratory (cystic fibrosis genotyping, Breast cancer susceptibility gene (BRCA 1&2), Methylenetetrahydrofolate reductase (MTHFR), factor V Leiden (FVL), prothrombin gene pathogenic variant, alpha‐thalassemia, hemochromatosis, and cell‐free fetal DNA). Charts were reviewed retrospectively by a licensed, certified genetic counselor to assess the compliance with published clinical practice guidelines identified on GeneReviews and the American College of Obstetricians and Gynecologists (ACOG). Tests were classified as: appropriate, misordered/not indicated, misordered/false reassurance, and misordered/inadequate. We performed a cost analysis for the recommended test changes. We reviewed 114 charts over a three‐month period. Forty‐four (38.6%) of the tests were misordered based on published clinical practice guidelines: 24 (21%) were misordered/not indicated, 8 (7%) were misordered/false reassurance, and 12 (10.5%) were misordered/inadequate. Costs of ordered testing ($75,177) were compared to recommended testing after review ($54,265), with a total cost savings of $20,912. In clinical practice, over one‐third of genetic tests reviewed were misordered. As these tests are a small fraction of all genetic tests at our institution, future studies should broaden the scope of testing evaluated to understand the magnitude of this problem and potential cost savings. Genetic counselor review and involvement in genetic test ordering can decrease inappropriate healthcare expenditures and improve patient care. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|