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Specialty care and education associated with greater disease-specific knowledge but not satisfaction with care for
L A Beste1, K Straits-Troster, S Zickmund
1Health Services Research and Development Center of Excellence, VA Puget Sound Healthcare System, Seattle, WA 98101, USA. Lauren.beste@va.gov
Background:
Little is known about differences among hepatitis C virus (HCV) patients managed by generalists vs. specialists with respect to patient-centred outcomes, such as disease-specific knowledge, health-related quality of life (HRQoL) and satisfaction with care.
Aim:
To examine selected patient-centred outcomes of HCV-related care provided in primary care, specialty care or both.
Methods:
A total of 629 chronic HCV patients completed a survey including an HCV knowledge assessment and validated instruments for satisfaction and HRQoL. Multivariable linear regression was used to compare outcomes between groups.
Results:
Adjusted total HCV knowledge score was lower among patients who did not attend specialty care (P < 0.01). Primary care and specialty patients did not differ in adjusted general HRQoL or satisfaction. Sixty percent of specialty patients underwent formal HCV education, which was associated with 5% higher knowledge score (P = 0.01). General HRQoL and patient satisfaction did not differ between primary care and specialty groups. Disease-specific knowledge and care satisfaction were independent of mental illness, substance abuse, socio-economic variables, history of antiviral treatment, formal HCV education and duration of time between last visit and survey completion.
Conclusions:
Primary care patients with chronic HCV have lower adjusted disease-specific knowledge than specialty patients, but no difference in general HRQoL or patient satisfaction.
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