| Obtaining insurance after DNA diagnostics: a survey among hypertrophic cardiomyopathy mutation carriers. | |
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MedLine Citation:
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PMID: 19672285 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Hypertrophic cardiomyopathy (HCM) is a common hereditary heart disease associated with increased mortality. Disclosure of DNA test results may have social implications such as low access to insurance. In The Netherlands, insurance companies are restricted in the use of genetic information of their clients by the Medical Examination Act. A cross-sectional survey was used to assess the frequency and type of problems encountered by HCM mutation carriers applying for insurance, and associations with carriers' characteristics. The response rate was 86% (228/264). A total of 66 carriers (29%) applied for insurance of whom 39 reported problems (59%) during an average follow-up of 3 years since the DNA test result. More problems were encountered by carriers with manifest disease (P<0.001) and carriers with symptoms of HCM (P=0.049). Carriers identified after predictive DNA testing less frequently experienced problems (P=0.002). Three carriers without manifest HCM reported problems (5% of applicants). Frequently reported problems were higher premium (72%), grant access to medical records (62%), and complete rejection (33%). In conclusion, HCM mutation carriers frequently encounter problems when applying for insurances, often in the case of manifest disease, but the risk assessment of insurance companies is largely justified. Still, 5% of carriers encounter potentially unjustified problems, indicating the necessity to monitor the application of the existing laws and regulations by insurance companies and to educate counselees on the implications of these laws and regulations. |
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Authors:
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Imke Christiaans; Tjitske M Kok; Irene M van Langen; Erwin Birnie; Gouke J Bonsel; Arthur A M Wilde; Ellen M A Smets |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-08-12 |
Journal Detail:
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Title: European journal of human genetics : EJHG Volume: 18 ISSN: 1476-5438 ISO Abbreviation: Eur. J. Hum. Genet. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-15 Completed Date: 2010-02-24 Revised Date: 2011-07-22 |
Medline Journal Info:
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Nlm Unique ID: 9302235 Medline TA: Eur J Hum Genet Country: England |
Other Details:
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Languages: eng Pagination: 251-3 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands. i.christiaans@amc.uva.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cardiomyopathy, Hypertrophic / economics, genetics* Carrier State / economics* Cross-Sectional Studies Demography Educational Status Ethnic Groups / genetics Family Female Health Surveys Humans Insurance Selection Bias* Insurance, Health* Insurance, Life* Male Middle Aged Mutation Netherlands Pensions Questionnaires |
| Comments/Corrections | |
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