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Duplicate hepatitis C antibody testing in New York City, 2006-2010
Victoria Tsai1, Katherine Bornschlegel2, Emily McGibbon2
1New York City Department of Health and Mental Hygiene, Long Island City, NY ; Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY ; Current affiliation: Maryland Department of Health and Mental Hygiene, Baltimore, MD.
Insights
Repeating hepatitis C virus antibody tests is wasteful and indicates poor care coordination. Over 70,000 duplicate tests in NYC from 2006-2010 cost $1.4 million, highlighting a need for better patient data management.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Hepatitis C virus (HCV) antibody testing is crucial for diagnosis.
- Repeated antibody testing in individuals already known to be positive is medically unnecessary.
Purpose of the Study:
- To quantify the extent of duplicate HCV antibody testing in New York City.
- To identify patient and facility-level factors associated with unnecessary repeat testing.
Main Methods:
- Analysis of public health surveillance data from the New York City Department of Health and Mental Hygiene (2006-2010).
- Utilized a polytomous logistic regression model to assess risk factors for duplicate testing.
Main Results:
- 70,257 duplicate HCV antibody tests were performed on 58,886 individuals between 2006 and 2010.
- Estimated cost of these duplicate tests was $1.4 million.
- Individuals in correctional facilities and substance abuse treatment centers showed higher rates of duplicate testing.
Conclusions:
- Duplicate HCV antibody testing is a significant issue, leading to substantial resource waste.
- Improved medical information coordination is essential for HCV-positive individuals.
- Focusing on integrated care can ensure appropriate follow-up and treatment services for hepatitis C.
Abstract:
Repeating a hepatitis C virus antibody test for a person who previously tested positive provides no new information, wastes resources, and may reflect poor coordination of medical care. Using public health surveillance data collected by the New York City Department of Health and Mental Hygiene, we evaluated the magnitude of duplicate antibody testing and assessed patient-level and facility-level risk factors for duplicate testing. From 2006 to 2010, 70,257 duplicate tests were performed for 58,886 individuals in New York City, costing an estimated $1.4 million. Analyses using a polytomous logistic regression model indicated that individuals in correctional and substance abuse treatment facilities were more likely to undergo duplicate testing. Future efforts should focus on coordinating medical information and care for hepatitis C antibody-positive individuals to ensure that the recommended diagnostic follow-up and treatment services are provided.
