Viktor V Chirikov1, Fadia T Shaya1,2, C Daniel Mullins1, Susan dosReis1, Ebere Onukwugha1, Charles D Howell3. 1. a 1 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, Saratoga Offices 12th Floor, Baltimore, MD 21201, USA. 2. b 2 University of Maryland School of Medicine, Baltimore, MD, USA. 3. c 3 Department of Medicine, Howard University College of Medicine, 2041 Georgia Ave. Suite 5C02, Washington, DC 20060, USA.
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.
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 HCVpatients, 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 HCVpatients, 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.
Entities:
Keywords:
Medicare disabled; contextual analysis; quality of care; substance; substance abuse; vulnerable population
Authors: Philip Vutien; Michelle Jin; Michael H Le; Pauline Nguyen; Sam Trinh; Jee-Fu Huang; Ming-Lung Yu; Wan-Long Chuang; Mindie H Nguyen Journal: PLoS One Date: 2017-09-06 Impact factor: 3.240