title: Quality of hepatitis C care at an urban tertiary care medical center.
abstract: BACKGROUND
  More effective treatment for hepatitis C virus (HCV) creates an opportunity to improve health outcomes.
  
  
  OBJECTIVE
  To use Centers for Medicare and Medicaid Services (CMS)-defined HCV quality indicators (QI) as a framework to assess the quality of care at an urban safety net hospital.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Patients engaged in care (at least two outpatient visits, and minimum six-month follow-up time) between 2005 and 2011. Outcomes measures. 1) HCV ribonucleic acid (RNA); 2) genotyping; 3) treatment; and 4) Hepatitis A and B vaccination. Study time was divided into three periods: 1) 2005-2006, 2) 2007-2008, 3) 2009-2011. Key results. Number who met inclusion criteria: 3,018; 13% were human immunodeficiency virus co-infected. Only 1% completed the care recommended in the CMS quality indicators that were evaluated. Later time periods were independently associated with greater rates (aHR for HCV testing, 1.15; 95% CI, 1.04-1.28).
  
  
  CONCLUSIONS
  Quality of care is improving, but it remains suboptimal. Initiatives are needed to increase QI completion.
authors.forename: Sabrina A
authors.initials: SA
authors.lastname: Assoumou
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: C Robert
authors.initials: CR
authors.lastname: Horsburgh
authors.lastname: Mus
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Linas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D055088:Early Detection of Cancer; D005260:Female; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000592:standards*; D019037:Urban Health Services / Q000592:standards*; D014761:Viral Hepatitis Vaccines / Q000627:therapeutic use; D019562:Viral Load; D055815:Young Adult
chemical_list: D014761:Viral Hepatitis Vaccines