title: Compliance with referral for hepatitis C evaluation among veterans.
abstract: OBJECTIVE
  The goals of this study were to quantify the rate and to identify predictors of compliance with outpatient hepatitis C evaluation.
  
  
  BACKGROUND
  Challenges in hepatitis C management include patient compliance with multiple clinic visits, laboratory tests, and radiologic studies throughout the management of hepatitis C. However, the success of hepatitis C management begins with the patient's compliance with referral for hepatitis C evaluation.
  
  
  METHODS
  The administrative databases and medical records of patients who were newly referred to the Durham Veterans Affairs Medical Center for hepatitis C evaluation between 2002 and 2004 were reviewed.
  
  
  RESULTS
  A total of 376 veterans were identified as being newly referred to the Durham Veterans Affairs Medical Center gastroenterology and liver clinics for hepatitis C evaluation. The mean age of referred patients was 51.2+/-6.1 years, and 94.7% were men. The majority of patients (87%) were compliant with referral for hepatitis C evaluation. In multivariable logistic regression adjusting for age, race, marital status, history of psychiatric disease, history of substance abuse, origin of referral, and wait time, keeping other outpatient appointments was a significant predictor of compliance with referral for hepatitis C evaluation (odds ratio 6.00; 95% confidence interval 1.52, 23.67).
  
  
  CONCLUSIONS
  Veterans have a high rate of compliance with referral for hepatitis C evaluation, and their compliance is likely reflective of their motivation to maintain general health care. Future studies assessing other factors, such as patient educational level and socioeconomic status, may help to elucidate more fully the factors impacting compliance with hepatitis C management.
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University Medical Center, Durham, NC 27710, USA. brady017@mc.duke.edu
authors: Carla W
authors: CW
authors: Brady
authors: Cynthia J
authors: CJ
authors: Coffman
authors: Dawn
authors: D
authors: Provenzale
mesh_terms: D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis*; D006787:Hospitals, Veterans; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D009657:North Carolina; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000150:complications; D014728:Veterans / Q000706:statistics & numerical data