Patient characteristics and neighborhood attributes associated with hepatitis C screening and positivity in Philadelphia.

Autor:	Lee DH; Drexel University College of Medicine and Drexel University Physicians Practice Plan, Philadelphia, PA, United States., Chou EY; Drexel University College of Medicine and Drexel University Physicians Practice Plan, Philadelphia, PA, United States., Moore K; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States., Melly S; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States., Zhao Y; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States., Chen H; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States., Buehler JW; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.; Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.
Jazyk:	angličtina
Zdroj:	Preventive medicine reports [Prev Med Rep] 2022 Oct 03; Vol. 30, pp. 102011. Date of Electronic Publication: 2022 Oct 03 (Print Publication: 2022).
DOI:	10.1016/j.pmedr.2022.102011
Abstrakt:	Among patients of an urban primary care network in Philadelphia with a universal hepatitis C virus (HCV) screening policy for patients born during 1945-1965, we examined whether being unscreened and HCV positivity were associated with attributes of the census tracts where patients resided, which we considered as proxies for social health determinants. For patients with at least one clinic visit between 2014 and mid-2017, we linked demographic and HCV screening information from electronic health records with metrics that described the census tracts where patients resided. We used generalized estimating equations to estimate adjusted relative risk ratios (aRRs) for being unscreened and HCV positive. Overall, 28% of 6,906 patients were unscreened. Black race, male gender, and residence in census tracts with relatively high levels of violent crime, low levels of educational attainment and household incomes, and evidence of residential segregation by Hispanic ethnicity were associated with lower aRRs for being unscreened. Among screened patients, 9% were HCV positive. Factors associated with lower risks of being unscreened were, in general, associated with higher HCV positivity. Attributes of census tracts where patients reside are probably less apparent to clinicians than patients' gender or race but might reflect unmeasured patient characteristics that affected screening practices, along with preconceptions regarding the likelihood of HCV infection based on prior screening observations or implicit biases. Approaching complete detection of HCV-infected people would be hastened by focusing on residents of census tracts with attributes associated with higher infection levels or, if known, higher infection levels directly. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2022 The Authors.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu