• Am J Manag Care · Aug 2021

    Randomized Controlled Trial

    Impact of expanded carrier screening on health care utilization.

    • Tia L Kauffman, John F Dickerson, Frances L Lynch, Michael C Leo, Elizabeth Shuster, Benjamin S Wilfond, Patricia Himes, Marian J Gilmore, Nancy J Rollins, and GoddardKatrina A BKAB.
    • Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Ave, Portland, OR 97227. Email: tia.l.kauffman@kpchr.org.
    • Am J Manag Care. 2021 Aug 1; 27 (8): 316-321.

    ObjectivesTo evaluate potential consequences of expanded carrier screening (ECS) for reproductive risk on health care utilization among women who are not at increased reproductive risk.Study DesignWomen planning pregnancy were randomized to usual care carrier screening or ECS to assess reproductive risks. Electronic health record (EHR) data were used to evaluate the effects of ECS on pregnancy-related utilization and general health care utilization among all study participants who did not receive positive ECS results of at least a 25% risk (ie, received negative [normal] ECS results).MethodsEHR data were extracted through research-ready databases and extensive chart review for 304 participants. We analyzed the effect of ECS for women who were not found to be at increased reproductive risk on (1) utilization of mental health services in the period between randomization and initial results disclosure; (2) utilization of general outpatient and inpatient services, specialty services, and mental health-related services in the year following randomization; and (3) utilization and refusal of pregnancy-related services among pregnant women (n = 129) prior to and following randomization.ResultsNo significant differences in health care utilization were found between women randomized to receive ECS and those receiving usual care. Women who received negative ECS results did not refuse recommended screening for conditions that are not identified via ECS at a higher rate than women in the usual care arm.ConclusionsThese results suggest that ECS does not have unintended negative impacts on the health care system for the majority of patients who are not at increased reproductive risk.

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