Canadian Journal of Gastroenterology and Hepatology

Canadian Journal of Gastroenterology and Hepatology / 2009 / Article

Original Article | Open Access

Volume 23 |Article ID 216903 |

Karen Doucette, Vicki Robson, Stephen Shafran, Dennis Kunimoto, "Improving Access to Care by Allowing Self-Referral to a Hepatitis C Clinic", Canadian Journal of Gastroenterology and Hepatology, vol. 23, Article ID 216903, 4 pages, 2009.

Improving Access to Care by Allowing Self-Referral to a Hepatitis C Clinic

Received27 Oct 2008
Accepted25 Dec 2008


BACKGROUND: Estimates suggest that more than 250,000 Canadians are infected with hepatitis C virus (HCV), but less than 10% have been treated. Access to specialists in Canada is usually via health care professional (HCP) referral and, therefore, may be a barrier to HCV care. However, clinics that operate in conjunction with the Hepatitis Support Program, Edmonton, Alberta, allow self-referral. It is hypothesized that this improves access to care without increasing inappropriate referrals.OBJECTIVE: To compare the baseline characteristcs and outcomes of HCV patients who self-referred with those who were HCP-referred.METHODS: Data were collected from the Hepatitis Support Program HCV database and chart reviews.RESULTS: Between December 17, 2002, and December 31, 2007, 1563 patients were referred including 336 self- (21.5%) and 1227 HCP- referrals (78.5%). Self- and HCP-referred patients were similar in terms of age (mean [± SD] 43.0±10.3 years versus 43.9±10.0 years, respectively; P=0.18), sex (56.8% versus 62.0% [men], respectively; P=0.08) and risk factors for HCV (P=0.3), with 49.7% and 52.6%, respectively, identifying injection drug use as the primary risk factor. The two groups had similar HCV genotype distributions and liver biopsy fibrosis scores with similar treatment rates (31.3% versus 33.2%; P=0.6). Treatment outcomes were excellent (sustained virological response 40.2% for genotype 1, 67% for genotypes 2 and 3) in patients completing therapy and were similar between the two groups.Conclusion: Self-referred patients comprised 21.5% of patients accessing care in the clinic. Self- and HCP-referred patients had similar characteristics, treatment rates and outcomes. Facilitating self- referral to an HCV clinic can improve access to care, including risk reduction education and HCV treatment.

Copyright © 2009 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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