title: Improving Healthcare Systems to Reduce Healthcare Disparities in Viral Hepatitis.
abstract: Chronic hepatitis B (CHB) and C (CHC) represent significant public health problems worldwide. Combined, over 7 million persons in the USA are chronically infected with either the hepatitis B or the hepatitis C virus. Although the populations affected by the viruses differ, both CHB and CHC are ideal conditions for preventive screening because of a high prevalence and low rate of diagnosis; an early asymptomatic period; highly sensitive and specific test; and treatments which have been shown to result in improved clinical outcomes including liver-related mortality and hepatocellular carcinoma. Improving healthcare delivery for CHB and CHC requires interventions that will increase screening for the infections, expanded capacity for evaluation and monitoring of the infection, and ultimately improved access to treatment. Many of these interventions may leverage opportunities within electronic health records, but must also address unique social, cultural, and language barriers that may prevent effective implementation of novel interventions. Herein, we will review current knowledge related to strategies employed to improve healthcare systems to reduce disparities in viral hepatitis.
authors.affiliation: Division of Gastroenterology and Hepatology, UC Davis Medical Center, 4150 V Street #3500, Sacramento, CA, 95817, USA. echak@ucdavis.edu.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Chak
authors.affiliation: Division of Gastroenterology and Hepatology, UC Davis Medical Center, 4150 V Street #3500, Sacramento, CA, 95817, USA.
authors.forename: Souvik
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Division of Gastroenterology and Hepatology, UC Davis Medical Center, 4150 V Street #3500, Sacramento, CA, 95817, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bowlus
mesh_terms: D001213:Asian / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular / Q000401:mortality; D003144:Communication Barriers; D003469:Culture; D003695:Delivery of Health Care; D055030:Drug Users / Q000706:statistics & numerical data; D042241:Early Diagnosis; D061345:Early Medical Intervention; D057286:Electronic Health Records; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy; D006801:Humans; D008107:Liver Diseases / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality; D008403:Mass Screening; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D015995:Prevalence; D058996:Quality Improvement; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: Chronic hepatitis B; Chronic hepatitis C; Disparities; Linkage to care; Screening