Hepatitis C screening trends in a large integrated health system
Benjamin P Linas1, Haihong Hu2, Devra M Barter3
1HIV Epidemiology and Outcomes Research Unit, Section of Infectious Diseases, Boston Medical Center, Boston, Mass; Department of Epidemiology, Boston University School of Public Health, Boston, Mass.
The American Journal of Medicine
|February 4, 2014
Summary
Hepatitis C virus (HCV) screening is increasing but remains incomplete in the US. Routine screening is recommended to improve detection rates, as targeted approaches are insufficient.
Area of Science:
- Hepatology and Infectious Diseases
- Public Health and Epidemiology
- Health Services Research
Background:
- Hepatitis C virus (HCV) infection screening rates in the US remain low, between 1% and 12%, despite the availability of new therapies.
- Current trends in HCV screening practices across healthcare systems are not well-documented.
Purpose of the Study:
- To investigate trends and patterns of HCV antibody screening within a large integrated healthcare system.
- To identify patient and provider factors associated with HCV screening and assess screening positivity rates.
Main Methods:
- Retrospective analysis of electronic health records from Kaiser Permanente Mid-Atlantic States (KPMAS) from January 1, 2003, to December 31, 2012.
- Inclusion of 444,594 patients to determine screening proportions, cumulative incidence, positivity rates, performing provider types, and patient-level predictors.
Main Results:
- Overall, 15.8% of the cohort was screened for HCV during the study period.
- Adult primary care and obstetrics/gynecology providers conducted 75.9% of screenings, with an overall positivity rate of 3.8%.
- Screening was higher in younger patients and those with documented illicit drug use history; patients with missing drug use history were least likely to be screened.
Conclusions:
- While HCV screening rates are increasing, they remain insufficient to control the epidemic.
- Targeting screening based on documented drug use history is limited due to incomplete records.
- Routine, systematic HCV screening is proposed as the most effective strategy to enhance screening coverage.
Related Concept Videos
01:20Integrated Healthcare System
2.4K
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
2.4K
01:30Health Information Technology and Healthcare Information System
1.6K
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
1.6K
01:22Healthcare Associated Infections II: Preventive Measures
4.7K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
4.7K
01:25Hepatitis
86
Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
86
01:29Issues And Trends In Healthcare Delivery System
6.5K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
6.5K
01:28Viral Hepatitis I: Introduction
25
Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
25