title: Sociodemographic trends in national ambulatory care visits for hepatitis C virus infection.
abstract: Poor and non-white patients are disproportionately infected with the hepatitis C virus (HCV). The objective of this research is to determine sociodemographic patterns of HCV-related ambulatory care visits over time. Data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey-Outpatient (NHAMCS-OPD) for the years 1997-2005 were analyzed in 3-year intervals. Demographic and other variables were compared for each period, and multivariable logistic regression was performed to examine whether the likelihood of a visit being HCV-related (versus non-HCV) was independently associated with (1) race and/or (2) Medicaid status over time. The total number of HCV-related ambulatory visits more than doubled from 3,583,585 during the years 1997-1999 to 8,027,166 during 2003-2005. During this time, the proportion of non-whites and Medicaid recipients presenting for HCV-related visits approximately doubled (non-whites: 16% vs. 33%, P=0.04; Medicaid recipients: 10% vs. 25%, P=0.07). In 2003-2005, HCV-related visits were more than twice as likely to occur among non-white patients vs. white patients (OR=2.49; 95% CI: 1.60-3.86) and patients on Medicaid vs. non-Medicaid (3.49; 1.79-6.80). Our results show that HCV-associated ambulatory care visits are increasing, with a greater proportion of visits occurring among non-white patients and Medicaid recipients.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Ave, 2nd floor, Boston, MA 02118, USA. judith.tsui@bmc.org
authors.forename: Judith I
authors.initials: JI
authors.lastname: Tsui
authors.forename: Judith
authors.initials: J
authors.lastname: Maselli
authors.forename: Ralph
authors.initials: R
authors.lastname: Gonzales
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000639:trends*; D016009:Chi-Square Distribution; D005260:Female; D019538:Health Care Surveys; D006526:Hepatitis C / Q000208:ethnology / Q000628:therapy*; D006801:Humans; D007348:Insurance, Health / Q000639:trends; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000639:trends; D008875:Middle Aged; D016017:Odds Ratio; D017149:Private Sector / Q000639:trends; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult