Specialty care and education associated with greater disease-specific knowledge but not satisfaction with care for chronic hepatitis C.
BACKGROUND
Little is known about differences among hepatitis C virus (HCV) patients managed by generalists vs. specialists with respect to patient-centred outcomes, such as disease-specific knowledge, health-related quality of life (HRQoL) and satisfaction with care.


OBJECTIVE
To examine selected patient-centred outcomes of HCV-related care provided in primary care, specialty care or both.


METHODS
A total of 629 chronic HCV patients completed a survey including an HCV knowledge assessment and validated instruments for satisfaction and HRQoL. Multivariable linear regression was used to compare outcomes between groups.


RESULTS
Adjusted total HCV knowledge score was lower among patients who did not attend specialty care (P < 0.01). Primary care and specialty patients did not differ in adjusted general HRQoL or satisfaction. Sixty percent of specialty patients underwent formal HCV education, which was associated with 5% higher knowledge score (P = 0.01). General HRQoL and patient satisfaction did not differ between primary care and specialty groups. Disease-specific knowledge and care satisfaction were independent of mental illness, substance abuse, socio-economic variables, history of antiviral treatment, formal HCV education and duration of time between last visit and survey completion.


CONCLUSIONS
Primary care patients with chronic HCV have lower adjusted disease-specific knowledge than specialty patients, but no difference in general HRQoL or patient satisfaction.
Health Services Research and Development Center of Excellence, VA Puget Sound Healthcare System, Seattle, WA 98101, USA. Lauren.beste@va.gov
L A
LA
Beste
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K
Straits-Troster
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S
Zickmund
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M
Larson
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M
Chapko
J A
JA
Dominitz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005762:Gastroenterology / Q000592:standards*; D019698:Hepatitis C, Chronic / Q000628:therapy*; D006801:Humans; D008297:Male; D008511:Medicine / Q000592:standards; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards*; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult