Regular sources of medical care among persons with severe mental illness at risk of hepatitis C infection.
OBJECTIVE
An estimated 19.6 percent of persons with severe mental illness are infected with the hepatitis C virus. Given the pressing need to identify and treat persons with severe mental illness who are at risk of hepatitis C infection and transmission, the authors sought to estimate the proportion of hepatitis C-positive and -negative persons with severe mental illness who have a regular source of medical care.


METHODS
S: Data for this study were obtained from 777 adults with severe mental illness at four diverse geographic sites at which respondents with severe mental illness participated in a structured interview and laboratory testing for HIV infection, AIDS, hepatitis B infection, and hepatitis C infection.


RESULTS
In bivariate analyses, 54.2 percent of hepatitis C-positive and 62.5 percent of hepatitis C-negative study participants with severe mental illness had a regular source of medical care. In multivariate analyses in which potential confounders were statistically controlled for, hepatitis C-positive persons with severe mental illness were less than half as likely as hepatitis C-negative persons to have a regular source of care. Being older, married, insured, or employed or having self-reported health problems increased the likelihood of receiving care. Being black or male or living in a community with high exposure to community violence lowered those odds.


CONCLUSIONS
There is an urgent need to improve access to medical care for persons with severe mental illness, especially those who may be at high risk of or are already infected with the hepatitis C virus.
Swartz
Marvin S
MS
Department of psychiatry and behavioral sciences of Duke University Medical Center, Box 3173, Durham, North Carolina 27710, USA. marvin.swartz@duke.edu
Swanson
Jeffrey W
JW
Hannon
Michael J
MJ
Bosworth
Hayden S
HS
Osher
Fred C
FC
Essock
Susan M
SM
Rosenberg
Stanley D
SD
D000328:Adult; D015897:Comorbidity; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D014481:United States / Q000453:epidemiology