Improving access to care by allowing self-referral to a hepatitis C clinic.
Can J Gastroenterol
; 23(6): 421-4, 2009 Jun.
Article
em En
| MEDLINE
| ID: mdl-19543572
ABSTRACT
BACKGROUND:
Estimates suggest that more than 250,000 Canadians are infected with hepatitis C virus (HCV), but less than 10% have been treated. Access to specialists in Canada is usually via health care professional (HCP) referral and, therefore, may be a barrier to HCV care. However, clinics that operate in conjunction with the Hepatitis Support Program, Edmonton, Alberta, allow self-referral. It is hypothesized that this improves access to care without increasing inappropriate referrals.OBJECTIVE:
To compare the baseline characteristics and outcomes of HCV patients who self-referred with those who were HCP-referred.METHODS:
Data were collected from the Hepatitis Support Program HCV database and chart reviews.RESULTS:
Between December 17, 2002, and December 31, 2007, 1563 patients were referred including 336 self- (21.5%) and 1227 HCP-referrals (78.5%). Self- and HCP-referred patients were similar in terms of age (mean [+/- SD] 43.0+/-10.3 years versus 43.9+/-10.0 years, respectively; P=0.18), sex (56.8% versus 62.0% [men], respectively; P=0.08) and risk factors for HCV (P=0.3), with 49.7% and 52.6%, respectively, identifying injection drug use as the primary risk factor. The two groups had similar HCV genotype distributions and liver biopsy fibrosis scores with similar treatment rates (31.3% versus 33.2%; P=0.6). Treatment outcomes were excellent (sustained virological response 40.2% for genotype 1, 67% for genotypes 2 and 3) in patients completing therapy and were similar between the two groups.CONCLUSION:
Self-referred patients comprised 21.5% of patients accessing care in the clinic. Self- and HCP-referred patients had similar characteristics, treatment rates and outcomes. Facilitating self referral to an HCV clinic can improve access to care, including risk reduction education and HCV treatment.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Participação do Paciente
/
Encaminhamento e Consulta
/
Hepatite C
/
Assistência Ambulatorial
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article