The impact of insurance coverage on the prenatal genetic counseling process: An exploration of genetic counselors' experiences with TRICARE

2019 ◽  
Vol 39 (6) ◽  
pp. 448-455
Author(s):  
Jordan Brown ◽  
Suzanne O'Neill ◽  
Wendy DiNonno ◽  
Olivia Hess
2021 ◽  
Vol 8 ◽  
Author(s):  
Takeshi Sato ◽  
Tomohiro Ishii ◽  
Yu Yamaguchi ◽  
Yosuke Ichihashi ◽  
Daigo Ochiai ◽  
...  

The occurrence of fetuses suspected of having ambiguous genitalia will likely increase in the future. Currently, the impact of prenatal genetic counseling on parents' understanding and psychological preparedness has not been addressed. We provided prenatal genetic counseling to parents of two fetuses suspected of ambiguous genitalia. Case 1: At 22 weeks of gestation, swelling of the labia majora, and a clitoris-like structure were noted despite 46,XY detected in amniotic fluid cells. Case 2: At 28 weeks of gestation, bladder exstrophy and a scrotum-like structure were noted. At 32 weeks (Case 1) and 37 weeks (Case 2) of gestation, we shared information with parents regarding the possible difficulty of legal sex assignment at birth, and a scenario for registration of the birth certificate. At birth, both babies presented with ambiguous genitalia. For both cases, the parents remained calm on seeing their baby's genitalia for the first time. After a month, we shared medical information with parents, including karyotype, testosterone production capacity, and surgical schedule. In both cases parents assigned their respective baby's legal sex as male. Several months later, parents were questioned on prenatal genetic counseling. Case 1: Mother, “I was prepared to address our baby's genitalia calmly.” Father, “I understood the procedure of legal sex assignment.” Case 2: Mother, “Without counseling, I would have been more upset and worried.” Father, “We were assured that multidisciplinary experts would support us.” Prenatal genetic counseling provides reassurance to parents, who remain informed and emotionally secure throughout the legal sex assignment of their child.


2018 ◽  
Vol 27 (2) ◽  
pp. 235-243 ◽  
Author(s):  
Sanne L. van der Steen ◽  
Diewertje Houtman ◽  
Iris M. Bakkeren ◽  
Robert-Jan H. Galjaard ◽  
Marike G. Polak ◽  
...  

2010 ◽  
Vol 20 (2) ◽  
pp. 178-191 ◽  
Author(s):  
Catherine M. Griswold ◽  
Stephanie S. Ashley ◽  
Shannan DeLany Dixon ◽  
Jessica L. Scott

2017 ◽  
Vol 75 (2) ◽  
pp. 131-152 ◽  
Author(s):  
Joshua Breslau ◽  
Bradley D. Stein ◽  
Bing Han ◽  
Shoshanna Shelton ◽  
Hao Yu

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders’ children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.


2006 ◽  
Vol 25 (3) ◽  
pp. 193-219 ◽  
Author(s):  
LINDA M. HUNT ◽  
HEIDE CASTAÑEDA ◽  
KATHERINE B. DE VOOGD

2017 ◽  
Vol 180 ◽  
pp. 28-35 ◽  
Author(s):  
Kimberly Narain ◽  
Marianne Bitler ◽  
Ninez Ponce ◽  
Gerald Kominski ◽  
Susan Ettner

2006 ◽  
Vol 15 (6) ◽  
pp. 409-431 ◽  
Author(s):  
Dana T. Kausmeyer ◽  
Eugene J. Lengerich ◽  
Brenda C. Kluhsman ◽  
Dorothy Morrone ◽  
Gregory R. Harper ◽  
...  

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