Hepatitis C risk assessment, testing and referral for treatment in urban primary care: role of race and ethnicity.
OBJECTIVE
To determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity.


METHODS
Retrospective chart review from four primary care sites in Philadelphia; two academic primary care practices and two community clinics was performed. Demographics, HCV risk factors, and other risk exposure information were collected.


RESULTS
Four thousand four hundred and seven charts were reviewed. Providers documented histories of injection drug use (IDU) and transfusion for less than 20% and 5% of patients, respectively. Only 55% of patients who admitted IDU were tested for HCV. Overall, minorities were more likely to have information regarding a risk factor documented than their white counterparts (79% vs 68%, P < 0.0001). Hispanics were less likely to have a risk factor history documented, compared to blacks and whites (P < 0.0001). Overall, minorities were less likely to be tested for HCV than whites in the presence of a known risk factor (23% vs 35%, P = 0.004). Among patients without documentation of risk factors, blacks and Hispanics were more likely to be tested than whites (20% and 24%, vs 13%, P < 0.005, respectively).


CONCLUSIONS
(1) Documentation of an HCV risk factor history in urban primary care is uncommon, (2) Racial differences exist with respect to HCV risk factor ascertainment and testing, (3) Minority patients, positive for HCV, are less likely to be referred for subspecialty care and treatment. Overall, minorities are less likely to be tested for HCV than whites in the presence of a known risk factor.
Trooskin
Stacey B
SB
Division of Gastroenterology and Hepatology, Thomas Jefferson University, Suite 480 Main Building, Philadelphia, PA 19107, USA.
Navarro
Victor J
VJ
Winn
Robert J
RJ
Axelrod
David J
DJ
McNeal
A Scott
AS
Velez
Maricruz
M
Herrine
Steven K
SK
Rossi
Simona
S
D000328:Adult; D044383:Black People / Q000208:ethnology*; D015331:Cohort Studies; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology* / Q000628:therapy; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014504:Urban Health; D044465:White People / Q000208:ethnology*; D001741:Black or African American