Hepatitis C risk assessment, testing and referral for treatment in urban primary care: Role of race and ethnicity
Hepatitis C risk assessment, testing and referral for treatment in urban primary care: Role of race and ethnicity
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DOI：
10.3748/wjg.v13.i7.1074
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发表时间：
2007-02-21
影响因子：
4.3
通讯作者：
Rossi, Simona
中科院分区：
文献类型：
--
作者：
Trooskin, Stacey B.;Navarro, Victor J.;Rossi, Simona
目的：确定城市初级保健实践中丙型肝炎（HCV）危险因素的确定、检测和转诊率，特别注意种族和民族的影响。方法：回顾性分析费城4个基层医疗点的图表；进行了两个学术初级保健实践和两个社区诊所。收集了人口统计学、HCV危险因素和其他风险暴露信息。结果：共审查了44,447张图表。提供者分别记录了不到20%和5%的患者有注射用药史和输血史。只有55%接受静脉注射的患者接受了丙型肝炎病毒检测。总体而言，少数民族比白人更有可能了解记录在案的风险因素信息（79%对68%，P < 0.0001）。与黑人和白人相比，西班牙裔人有危险因素病史记录的可能性较小（P < 0.0001）。总体而言，在存在已知危险因素的情况下，少数族裔接受HCV检测的可能性低于白人（23% vs 35%, P = 0.004）。在没有危险因素记录的患者中，黑人和西班牙裔比白人更有可能接受检测（分别为20%和24%，vs 13%, P < 0.005）。结论：(1)城市基层医疗机构对HCV危险因素病史的记录并不多见；(2)在HCV危险因素的确定和检测方面存在种族差异；(3)HCV阳性的少数族裔患者较少转诊接受亚专科护理和治疗。总的来说，在已知危险因素存在的情况下，少数族裔比白人更不可能接受丙型肝炎病毒检测。(c) 2007年WJG出版社。版权所有。
AIM: To determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity.METHODS: Retrospective chart review from four primary care sites in Philadelphia; two academic primary care practices and two community clinics was performed. Demographics, HCV risk factors, and other risk exposure information were collected.RESULTS: Four thousand four hundred and seven charts were reviewed. Providers documented histories of injection drug use (IDU) and transfusion for less than 20% and 5% of patients, respectively. Only 55% of patients who admitted IDU were tested for HCV. Overall, minorities were more likely to have information regarding a risk factor documented than their white counterparts (79% vs 68%, P < 0.0001). Hispanics were less likely to have a risk factor history documented, compared to blacks and whites (P < 0.0001). Overall, minorities were less likely to be tested for HCV than whites in the presence of a known risk factor (23% vs 35%, P = 0.004). Among patients without documentation of risk factors, blacks and Hispanics were more likely to be tested than whites (20% and 24%, vs 13%, P < 0.005, respectively).CONCLUSION: (1) Documentation of an HCV risk factor history in urban primary care is uncommon, (2) Racial differences exist with respect to HCV risk factor ascertainment and testing, (3) Minority patients, positive for HCV, are less likely to be referred for subspecialty care and treatment. Overall, minorities are less likely to be tested for HCV than whites in the presence of a known risk factor. (c) 2007 The WJG Press. All rights reserved.