Dataset Information

Canadian genetic healthcare professionals' attitudes towards discussing private pay options with patients.

ABSTRACT:

Background

Just as there is inconsistency with respect to coverage of genomic testing with insurance carriers, there is interprovincial discrepancy in Canada. Consequently, the option of private pay (e.g., self pay) arises, which can lead to inequities in access, particularly when patients may not be aware of this option. There are currently no published data regarding how the Canadian genetics community handles discussions of private pay options with patients. The purpose of this study was to assess the attitudes of genetic healthcare professionals (GHPs: medical geneticists, genetic counselors, and genetic nurses) practicing in Canada toward these discussions.

Methods

An online survey was distributed to members of the Canadian College of Medical Geneticists and the Canadian Association of Genetic Counsellors to assess frequencies, rationale, and ethical considerations regarding these conversations. Quantitative data were analyzed using descriptive statistics.

Results

Of 144 respondents, 95% reported discussing private pay and 65% reported working in a clinic without a policy on this issue. There were geographic and practice-specific differences. The most common circumstance for these discussions was when a test was clinically indicated (e.g., but funding was denied) followed by when the patient initiated the conversation. The most frequently discussed tests included: multi-gene panels (73% of respondents), noninvasive prenatal testing (62%), and pre-implantation genetic diagnosis (58%). Although 65% felt it was ethical to discuss private pay, 35% indicated it was "sometimes" ethical.

Conclusion

With the increasing availability of genomic technologies, these findings inform how we practice and demonstrate the need for policy in this area.

SUBMITTER: Di Gioacchino V

PROVIDER: S-EPMC6465662 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Canadian genetic healthcare professionals' attitudes towards discussing private pay options with patients.

Di Gioacchino Vanessa V Langlois Sylvie S Elliott Alison M AM

Molecular genetics & genomic medicine 20190202 4

<h4>Background</h4>Just as there is inconsistency with respect to coverage of genomic testing with insurance carriers, there is interprovincial discrepancy in Canada. Consequently, the option of private pay (e.g., self pay) arises, which can lead to inequities in access, particularly when patients may not be aware of this option. There are currently no published data regarding how the Canadian genetics community handles discussions of private pay options with patients. The purpose of this study ...[more]

PMID: 30712332

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Project description:IntroductionAttitudes towards cardiopulmonary resuscitation (CPR) among in-hospital healthcare professionals (HCPs) are poorly understood. The aim of this study was to evaluate attitudes towards CPR situations among in-hospital HCPs and assess associations with potential influencing factors.Materials and methodsA questionnaire was distributed to 3,085 HCPs in 2009 and 2,970 HCPs in 2015-2016. The associations of influencing factors were analyzed using binary logistic regression.ResultsIn the event of a possible cardiac arrest situation, 61% of the HCPs would feel confident in their CPR knowledge, 86% would know what to do, and 60% would be able to take command if necessary. In the latest real-life CPR situation, 30% had been worried about making mistakes or causing complications, 57% had been stressed, and 27% had been anxious. A short time since the latest real-life CPR performance and a high number of previous real-life CPR performances were associated with lower odds of worrying about making mistakes/causing complications, lower odds of feeling stressed or anxious, and higher odds of feeling calm. Regardless of previous real-life CPR experience, there were differences in attitudes between groups of professions, where physicians showed increased odds of worrying about making mistakes/causing complications and nurses showed increased odds of stress. Working on a non-monitored ward meant increased odds of stress and worrying about making mistakes/causing complications. Twelve months or more having passed since the latest CPR training course was associated with increased odds of anxiety.ConclusionsDespite HCPs' generally positive attitudes towards performing CPR in the event of a possible cardiac arrest situation, feelings of stress and anxiety were common in real-life CPR situations. Regular CPR training among all HCPs is a key factor to maintain competence and reduce anxiety. The possible effects of attitudes on performing CPR need to be studied further.

Project description:BackgroundDespite evidence of the positive impact of routine assessment of patient-reported outcome measures (PROMs), their systematic collection is not widely implemented in cancer care.AimTo assess the knowledge, use and attitudes of healthcare professionals (HCPs) towards PROMs and electronically collected PROMs (ePROMs) in clinical practice and research and to explore respondent-related factors associated with the above dimensions.MethodAn ad hoc developed online survey was administered to all HCPs employed in clinical activity in an Italian comprehensive cancer center. The survey investigated which PROMs were known and used, as well as HCPs' opinions on the advantages and drawbacks of routine PROM assessment, including electronic assessment (ePROM). Linear and logistic regression models were used for association analyses.ResultsFive Hundred Eleven of nine hundred ninety-two invited HCPs (52%) provided analyzable responses. 68% were women, 46% were nurses and 42% physicians, and 52.5% had > 20 years seniority. The average number of PROMs known was six among 17 proposed. All proved to be under-used (< 28%) except unidimensional and multidimensional pain scales (77 and 36%). Respondents expressed an overall positive attitude towards PROMs, with strengths outweighing weaknesses (mean overall scores 3.6 and 2.9, respectively, on a 1-5 scale). 67% of respondents preferred electronic collection over paper and pencil. Profession was associated with knowledge and use (physicians reported knowing more PROMs than other professionals) and with a preference for electronic collection (nurses were less likely to prefer the electronic format than physicians). Senior HCPs were slightly more critical about both PROMs and electronic administration.ConclusionsThis survey indicates an acceptable level of knowledge of common PROM tools but low usage in practice. Based on the generally positive attitude of HCPs, routine implementation of ePROMs can be promoted as long as adequate resources and training are provided.Trial registrationNot registered.

Dataset Information

Canadian genetic healthcare professionals' attitudes towards discussing private pay options with patients.

Background

Methods

Results

Conclusion

Publications

Canadian genetic healthcare professionals' attitudes towards discussing private pay options with patients.

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