Integrating Viral Hepatitis Prevention Services into an Urban STD Clinic: Denver, Colorado

Subiadur, Julie; Harris, Jennie; Rietmeijer, Cornelis A.

doi:10.1177/00333549071220s203

Cited by 18 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A pervasive problem encountered by public health programs implementing these screening recommendations is the limited availability of medical evaluation, follow-up, and treatment (including treatment with antiviral medications) for clients who have a positive HCV screening test and little or no health insurance. [5][6][7] The inability of many individuals with HCV infection to obtain recommended medical evaluation and care has stirred debate about the appropriateness of HCV screening. 8 This article describes an innovative program 9 that has substantially improved the availability and quality of care for New Mexicans living with hepatitis C. This program, Project Extension for Community Healthcare Outcomes (Project ECHO) (see http://hsc .unm.edu/medicine/echo.shtml), is a partnership of academic medicine, public health departments, corrections departments, and rural community clinics in New Mexico.…”

Section: Synopsismentioning

confidence: 99%

Project ECHO: Linking University Specialists with Rural and Prison-Based Clinicians to Improve Care for People with Chronic Hepatitis C in New Mexico

et al. 2007

View full text Add to dashboard Cite

Project Extension for Community Healthcare Outcomes (Project ECHO) is a telemedicine and distance-learning program designed to improve access to quality health care for New Mexicans with hepatitis C. Project ECHO links health-care providers from rural clinics, the Indian Health Service, and prisons with specialists at the University of New Mexico. At weekly clinics, partners present and discuss patients with hepatitis C with specialists. Partners can receive continuing education credits for participating. Since June 2003, 173 hepatitis C clinics have been conducted with 1,843 case presentations. Partners have received 390 hours of training and 2,997 hours of continuing education credits. And in 2006, the State Legislature approved $1.5 million in annual funding for the project. Project ECHO has increased access to state-of-the art hepatitis C virus care for patients living in rural areas or prisons. Because of its success with hepatitis C, this project is being expanded to other chronic medical conditions.

show abstract

Section: Synopsismentioning

confidence: 99%

Project ECHO: Linking University Specialists with Rural and Prison-Based Clinicians to Improve Care for People with Chronic Hepatitis C in New Mexico

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Despite these benefits, patient nonattendance rates range from 28 to 80% [14–16], and little is known about the reasons for this. Nonattendance results in wasted clinician time and health care resources, but a more critical issue is the delay in presentation and lack of monitoring and management that can predispose the patient to complications unnecessarily.…”

Section: Introductionmentioning

confidence: 99%

Reasons for Nonattendance across the Hepatitis C Disease Course

et al. 2013

View full text Add to dashboard Cite

This descriptive qualitative study examined the patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care throughout the disease course. Eighty-four patients and health and social care providers were interviewed. Thematic analysis of the data yielded 6 interrelated nonattendance themes: self-protection, determining the benefits, competing priorities, knowledge gaps, access to services, and restrictive policies. Factors within the themes varied with the disease course, type of provider/service, and patient context. Nonattendance could span months to years and most frequently began at diagnosis where providers either advised that followup was not necessary or did not recommend any followup. The way services were organized (low barrier access) and delivered (nonjudgmental approach) and higher HCV knowledge levels of patients and providers encouraged attendance. This is the first study to explore the reasons for nonattendance for HCV care throughout the disease course and validate them from multiple perspectives. There are missed opportunities for providers to encourage attendance throughout the disease course beginning at diagnosis. Interventions required include development of integrated health and social service delivery models; mechanisms to improve knowledge dissemination of the disease, its management, and treatment; and implementation of standardized followup protocols for liver disease monitoring in primary care.

show abstract

“…3,11 The CER for testing IDUs-$54 per true positive tester who receives results-was far below that of any other group. IDUs are widely recognized as the risk group accounting for the 4 Clinics may test people who do not report injecting drugs because they are concerned that some clients fail to disclose this behavior. 7 Clients and counselors may also mistakenly believe that tattoos/piercings and sexual risks are significant risk factors for HCV infection.…”

Section: Discussionmentioning

confidence: 99%

The Costs and Impacts of Testing for Hepatitis C Virus Antibody in Public STD Clinics

et al. 2007

Self Cite

View full text Add to dashboard Cite

SynopSiSobjectives. To estimate the cost and cost-effectiveness of testing sexually transmitted disease (STD) clinic subgroups for antibodies to hepatitis C virus (HCV).Methods. HCV counseling, testing, and referral (CTR) costs were estimated using data from two STD clinics and the literature, and are reported in 2006 dollars. Effectiveness of HCV CTR was defined as the estimated percentage of clinic clients in subgroups targeted for HCV antibody (anti-HCV) testing who had a true positive test and returned for their test results. We estimated the cost per true positive injection drug user (IDU) who returned for anti-HCV test results and the cost-effectiveness of expanding HCV CTR to non-IDU subgroups.Results. The estimated cost per true positive IDU who returned for test results was $54. The cost-effectiveness of expanding HCV CTR to non-IDU subgroups ranged from $179 to $2,986. Our estimates were most sensitive to variations in HCV prevalence, the cost of testing, and the rate of client return.Conclusions. Based on national data, testing IDUs in the STD clinic setting is highly cost-effective. Some clinics may find that it is cost-effective to expand testing to non-IDU men older than 40 who report more than 100 lifetime sex partners. STD clinics can use study estimates to assess the feasibility and desirability of expanding HCV CTR beyond IDUs.

show abstract

Integrating Viral Hepatitis Prevention Services into an Urban STD Clinic: Denver, Colorado

Cited by 18 publications

References 0 publications

Project ECHO: Linking University Specialists with Rural and Prison-Based Clinicians to Improve Care for People with Chronic Hepatitis C in New Mexico

Project ECHO: Linking University Specialists with Rural and Prison-Based Clinicians to Improve Care for People with Chronic Hepatitis C in New Mexico

Reasons for Nonattendance across the Hepatitis C Disease Course

The Costs and Impacts of Testing for Hepatitis C Virus Antibody in Public STD Clinics

Contact Info

Product

Resources

About