title: High rates of uninsured among HCV-positive individuals.
abstract: OBJECTIVE
  There are no published data on the health insurance status of Hepatitis C virus (HCV)-positive individuals. To address this issue, we analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III).
  
  
  METHODS
  Individuals 18 years of age and older who participated in NHANES III were included in the study. We determined the rates of health insurance coverage according to HCV status. We also determined healthcare status and health service utilization according to health insurance status among HCV-positive persons.
  
  
  RESULTS
  HCV-positive individuals were more likely to be uninsured compared with those who were HCV-negative (29.6% vs. 12.2%, P = 0.0002). Among those with health insurance, HCV-positive individuals were more likely to have government insurance compared with those who were HCV-negative (42.9% vs. 27.6%, P < 0.005). Among HCV-positive individuals, being uninsured was associated with younger age, being unmarried, living in the South, Mexican-American race/ethnicity, and not graduating from high school. Additionally, the uninsured were less likely than their insured counterparts to identify a healthcare facility for sick or routine care, and less likely to have regular contact with a healthcare professional.
  
  
  CONCLUSIONS
  A high proportion of HCV-positive individuals are uninsured, and many HCV-positive individuals with health insurance have publicly funded insurance. This finding may have implications for access to health care and for liver-related disease outcomes in HCV-positive persons.
authors.affiliation: Center for Liver Diseases, Inova Fairfax Hospital, Annandale, VA 22003, USA. janus.ong@inova.com
authors.forename: Janus P
authors.initials: JP
authors.lastname: Ong
authors.forename: Rochelle
authors.initials: R
authors.lastname: Collantes
authors.forename: Angela
authors.initials: A
authors.lastname: Pitts
authors.forename: Lisa
authors.initials: L
authors.lastname: Martin
authors.forename: Michael
authors.initials: M
authors.lastname: Sheridan
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000191:economics* / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D007348:Insurance, Health; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology