title: Using latent class analysis to identify patterns of hepatitis C service provision in drug-free treatment programs in the U.S.
abstract: Hepatitis C virus (HCV) infection is a global health problem, and in many countries (including the U.S.), illicit drug users constitute the group at greatest risk for contracting and transmitting HCV. Drug treatment programs are therefore unique sites of opportunity for providing medical care and support for many HCV infected individuals. This paper determines subtypes of a large sample of U.S. drug-free treatment programs (N=333) according to services they provide to patients with HCV infection, and examines the organizational and aggregate patient characteristics of programs in these subtypes. A latent class analysis identified four subtypes of HCV service provision: a "Most Comprehensive Services" class (13% of the sample), a "Comprehensive Off-Site Medical Services" class (54%), a "Medical Monitoring Services" class (8%) and a "Minimal Services" class (25%). "Comprehensive" services class programs were less likely to be outpatient and private for profit than those in the other two classes. It is of concern that so many programs belong to the "Minimal Services" class, especially because some of these programs serve many injection drug users. "Minimal Services" class programs in the U.S. need to innovate services so that their HCV infected patients can get the medical and support care they need. Similar analyses in other countries can inform their policy makers about the capacity of their drug treatment programs to provide support to their HCV infected patients.
authors.affiliation: National Development and Research Institutes, Inc., 71 West 23rd Street, 8th floor, New York, NY 10010, USA. strauss@ndri.org
authors.forename: Shiela M
authors.initials: SM
authors.lastname: Strauss
authors.forename: David M
authors.initials: DM
authors.lastname: Rindskopf
authors.forename: Janetta M
authors.initials: JM
authors.lastname: Astone-Twerell
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
mesh_terms: D019090:Case Management / Q000706:statistics & numerical data; D015897:Comorbidity; D003191:Comprehensive Health Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006526:Hepatitis C / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D013287:Illicit Drugs; D015233:Models, Statistical; D010343:Patient Admission / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States
chemical_list: D013287:Illicit Drugs