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Hepatitis vaccination in patients with hepatitis C: practice and validation of codes at a large Veterans

C Y Hachem1, J R Kramer, F Kanwal

  • 1Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. chachem@slu.edu

Alimentary Pharmacology & Therapeutics
|August 12, 2008
PubMed

Insights

Hepatitis vaccination codes accurately reflect vaccination status in administrative data. However, vaccination rates in hepatitis C virus (HCV)-infected patients remain low, indicating under-utilization.

Area of Science:

  • Hepatology
  • Vaccinology
  • Health Informatics

Background:

  • Hepatitis vaccination is crucial for patients with chronic liver disease.
  • Hepatitis C virus (HCV) infection necessitates preventive vaccination strategies.
  • Administrative databases are increasingly used for public health surveillance.

Purpose of the Study:

  • To validate Current Procedural Terminology (CPT) and drug codes for hepatitis vaccination in administrative databases.
  • To determine the actual rates of hepatitis vaccination among patients with HCV.
  • To assess the reliability of administrative data for tracking vaccination status.

Main Methods:

  • Validation of hepatitis vaccination codes using predictive values (PPV, NPV) in a patient cohort.
  • Retrospective cohort study of HCV-infected patients to determine vaccination and serological testing rates.
  • Analysis of vaccination data from a large Veterans Administration Medical Center.

Main Results:

  • Hepatitis A and B vaccine codes demonstrated high predictive values (PPV > 93%, NPV > 94%).
  • Hepatitis vaccination rates in HCV patients diagnosed between 2000-2005 were low, around 8% overall and 7% in those with cirrhosis.
  • Many unvaccinated patients lacked immunity testing or had negative serology, suggesting missed opportunities for vaccination.

Conclusions:

  • CPT and drug codes are reliable for identifying hepatitis vaccinations in administrative records.
  • Significant under-utilization of hepatitis vaccination exists among patients with HCV.
  • Improved vaccination strategies and data capture are needed for this vulnerable population.
Abstract

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