Pathologist Pediatric In-Patient Genetic Stewardship

Background: Costs for sendout genetic testing on in-patients are billed to the hospital. Turnaround times are several weeks, often extending past the inpatient hospitalization.Materials and Methods: We concurrently reviewed all sendout genetic in-patient test requests over an 18-month period, deferring those that could be obtained as an outpatient, directing the tests to less expensive laboratories with complementary testing profiles, and identifying no-charge sponsored tests.Results: Of 121 test requests, 25 were deferred, alternative less expensive laboratories were identified for 8, 16 requests were directed to sponsored tests, for a 42.3% cost saving. Of the 96 tests sent, 18 (18.8%) identified an explanatory genetic abnormality.Conclusions: Approximately 40% of the sendout genetic testing costs were reduced with prior test review. Deferment, alternative laboratories, and sponsored tests contributed to cost savings. Efficiency of diagnostic inpatient genetic testing was approximately 20%.