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 language | English (US) |
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Pages (from-to) | 1447-1462 |
Number of pages | 16 |
Journal | Expert Review of Gastroenterology and Hepatology |
Volume | 9 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2 2015 |
Externally published | Yes |
Keywords
- contextual analysis
- Medicare disabled
- quality of care
- substance
- substance abuse
- vulnerable population
ASJC Scopus subject areas
- Hepatology
- Gastroenterology