Financial barriers in a county genetics clinic: Problems and solutions

Area of Science:

• Medical Genetics
• Health Services Research
• Health Equity

Background:

• Genetic evaluations are crucial for diagnosis, prognosis, and risk assessment.
• Healthcare disparities exist due to limited access to genetics services for low socioeconomic and minority groups.
• County hospital systems can play a role in reducing these inequalities.

Purpose of the Study:

• To assess the accessibility and completion of genetic testing in an underserved population.
• To identify barriers to genetic testing within a county hospital genetics clinic.
• To explore strategies for overcoming financial barriers to genetic testing.

Main Methods:

• Retrospective chart review of 2,304 patients at a county hospital genetics clinic (2013-2018).
• Analysis of recommended genetic tests, financial resources utilized, and reasons for non-completion.
• Evaluation of patient demographics and socioeconomic factors.

Main Results:

• Genetic testing was recommended for 58.5% of patients (1,429 tests).
• Most tests (56.5%) were funded by non-hospital resources.
• Loss to follow-up during phlebotomy was the primary reason for tests not ordered (41.9%) and not completed (36.4%).

Conclusions:

• Financial barriers significantly impede genetic testing completion in underserved populations.
• Utilizing commercial laboratory financial assistance programs alongside hospital funds can improve access.
• Proactive identification of financial avenues is essential for healthcare providers to overcome barriers and reduce health disparities in genetic services.