Determinants of quality of care and treatment initiation in Medicare disabled patients with chronic hepatitis C

Viktor V. Chirikov, Fadia T. Shaya, C. Daniel Mullins, Susan Dosreis, Ebere Onukwugha, Charles D. Howell

Research output: Contribution to journalArticle

Abstract

Background: Aligning with a national priority to bridge health disparities in disadvantaged populations, we explored contextual determinants of pretreatment quality of care and treatment receipt of Medicare disabled patients with hepatitis C virus (HCV) infection. Methods: We used Medicare claims (2006-2009) linked to the Area Health Resource Files. Ordinal partial proportional odds and weighted modified Poisson regressions were used to model the determinants of quality care receipt and interferon-based treatment, respectively. Results: We identified 1936 Medicare disabled HCV patients, of whom 10.4% were treated with peg-interferon. Despite the high comorbidity burden among HCV disabled patients, greater engagement in care correlated with greater likelihood of quality care and treatment receipt. Conclusion: Our study highlights the need for process and linkage to care in Medicare disabled HCV patients, but future research relevant to novel interferon-free agents is needed to assess patterns of quality of care and treatment receipt in this vulnerable population.

Original languageEnglish (US)
Pages (from-to)1447-1462
Number of pages16
JournalExpert Review of Gastroenterology and Hepatology
Volume9
Issue number11
DOIs
StatePublished - Nov 2 2015
Externally publishedYes

Keywords

  • contextual analysis
  • Medicare disabled
  • quality of care
  • substance
  • substance abuse
  • vulnerable population

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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