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January 22, 2026American Journal of Medical Genetics Part A0 citationsOpen Access

Denial of Inpatient Genetic Testing: A Study on Outpatient Yield and Outcomes

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CCCindy Y. CanalesKSKathleen ShieldsMCMeagan Choates

Key Points

  • The research aims to compare the diagnostic yields of genetic testing in inpatient and outpatient settings and assess the implications of inpatient test denials.
  • Reviewed 1,052 charts of children admitted inpatient receiving genetic consults from July 2018 to June 2023.
  • Examined charts of children who followed up at outpatient genetics clinics after discharge.
  • Collected data on testing recommendations, completion, results, and management based on diagnoses.
  • Performed statistical analysis to assess differences between inpatient and outpatient groups.
  • Outpatient genetic testing showed nearly double the diagnostic yield compared to inpatient testing.
  • Management recommendations remained similar regardless of testing setting.
  • Private insurance holders and patients without premature birth history were less frequently approved for inpatient testing.

Abstract

ABSTRACT Genetic conditions suspected in children often require genetic testing for accurate diagnoses, but testing remains costly. Case management teams review genetic test requests to improve access for patients while reducing the financial burden for medical institutions. Limited data exist on the diagnostic yields of genetic testing in the inpatient versus outpatient setting and the impact to care denial of inpatient genetic testing may pose. This study investigates diagnostic yields between patients approved for versus denied inpatient genetic testing and its impact to care. One thousand and fifty‐two charts of children admitted inpatient who received a genetic consult between July 2018 and June 2023 were reviewed; charts of children that followed up at the outpatient genetics clinic after inpatient discharge were additionally reviewed. Collected data included recommendations, completion, and results of genetic testing, and management recommendations based on a diagnosis. Statistical analysis assessed differences between the groups. Private insurance holders and patients with no prematurity history were less likely to be approved for inpatient genetic testing. The outpatient group had nearly twice the diagnostic yield and management recommendations did not differ between the groups. Inclusion of genetic providers in the review of inpatient genetic testing requests should be considered to improve outcomes.

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Cite This Study

Canales et al. (2026) studied this question.

synapsesocial.com/papers/6971bdcf642b1836717e2832https://doi.org/10.1002/ajmga.70041
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