Multidisciplinary managed care networks-Life-saving interventions for hepatitis C patients

Area of Science:

• Hepatology and Viral Hepatitis Research
• Public Health and Epidemiology
• Healthcare Management and Policy

Background:

• Effective hepatitis C virus (HCV) care pathways are crucial for successful therapy.
• Over two decades, sequential models of care, including a multidisciplinary managed care network, were developed to optimize HCV testing, care, and treatment.
• Evaluating these evolving care pathways is essential to understand their impact on patient outcomes.

Purpose of the Study:

• To assess the effectiveness of sequential HCV care pathways implemented over 20 years.
• To evaluate the impact of these pathways on patient access to treatment, sustained viral response, and all-cause mortality.
• To determine if a managed care network model improved patient outcomes in HCV management.

Main Methods:

• A retrospective cohort study analyzing 3122 HCV antibody-positive individuals diagnosed between 1994 and 2014.
• Patients were categorized into four subgroups based on distinct care pathways defined by diagnosis date.
• Outcomes measured included treatment access, treatment initiation rates, sustained viral response (SVR), and all-cause mortality, with multivariate analysis performed.

Main Results:

• Access to treatment services within 1 year of diagnosis increased from 26.3% to 72.9% across care pathways.
• Treatment initiation rates within 1 year rose from 2.0% to 16.2%, and SVR improved from 61.6% to 77.4%.
• All-cause mortality significantly decreased from 33.7% to 4.5%, with pathway type being an independent predictor of mortality.

Conclusions:

• The evolution of HCV care pathways, particularly the introduction of a managed care network, substantially improved patient access to care and treatment.
• These improved pathways led to higher sustained viral response rates and a significant reduction in all-cause mortality.
• Managed care networks represent a vital strategy for optimizing HCV patient outcomes and reducing mortality.