Racial Differences in the Evaluation and Treatment of Hepatitis C Among Veterans: A Retrospective Cohort Study

Autor:	Christopher W. Forsberg, Christine Rousseau, Meaghan F. Larson, Kevin L. Sloan, Jason A. Dominitz, George N. Ioannou, Jeffrey A. Todd-Stenberg
Rok vydání:	2008
Předmět:	Adult Male medicine.medical_specialty Medical Records Systems Computerized Research and Practice Hospitals Veterans Black People Antiviral Agents White People Cohort Studies Internal medicine Epidemiology medicine Humans Multicenter Studies as Topic Veterans Affairs health care economics and organizations Retrospective Studies Veterans medicine.diagnostic_test business.industry Medical record Public Health Environmental and Occupational Health Retrospective cohort study Hepatitis C Odds ratio Middle Aged medicine.disease humanities United States Surgery United States Department of Veterans Affairs Logistic Models Liver biopsy business Prejudice Cohort study
Zdroj:	American Journal of Public Health. 98:846-852
ISSN:	1541-0048 0090-0036
DOI:	10.2105/ajph.2007.113225
Popis:	Objectives. We examined the association between race and hepatitis C virus (HCV) evaluation and treatment of veterans in the Northwest Network of the Department of Veterans Affairs (VA). Methods. In our retrospective cohort study, we used medical records to determine antiviral treatment of 4263 HCV-infected patients from 8 VA medical centers. Secondary outcomes included specialty referrals, laboratory evaluation, viral genotype testing, and liver biopsy. Multiple logistic regression was used to adjust for clinical (measured through laboratory results and International Classification of Diseases, Ninth Revision, codes) and sociodemographic factors. Results. Blacks were less than half as likely as Whites to receive antiviral treatment (odds ratio [OR]=0.38; 95% confidence interval [CI]=0.23, 0.63). Both had similar odds of referral and liver biopsy. However, Blacks were significantly less likely to have complete laboratory evaluation (OR=0.67; 95% CI=0.52, 0.88) and viral genotype testing (OR=0.68; 95% CI=0.51, 0.90). Conclusions. Race is associated with receipt of medical care for various medical conditions. Further investigation is warranted to help understand whether patient preference or provider bias may explain why HCV-infected Blacks were less likely to receive medical care than Whites.
Databáze:	OpenAIRE
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