title: Limited provision of diagnostic services to Victorians living with hepatitis C antibodies, 2001-2012: a multi-level modelling analysis.
abstract: OBJECTIVE
  To determine what percentage of Victorians with a history of notified hepatitis C exposure received appropriate follow-up diagnostic services between 2001 and 2012.
  
  
  METHODS
  Individual notification data and aggregate Medicare and supplementary testing data were entered into a compartmental transition model, which was used to estimate the percentage of people with a hepatitis C notification who were yet to receive either a negative diagnostic test for viral nucleic acid, or a test for viral genotype, at the end of 2012.
  
  
  RESULTS
  We estimate that 58.2% (uncertainty interval: 42.2%, 72.4%) of Victorians with a hepatitis C notification between 2001 and 2012 did not receive either a negative test for viral nucleic acid or a viral genotyping test during the study period. At the end of 2012, we estimate there were approximately 20,400 Victorians living with hepatitis C antibodies who were yet to receive testing, of which approximately 9,300 would have been aged 45 years or older.
  
  
  CONCLUSIONS
  A majority of people living with HCV antibodies in Victoria had not received appropriate secondary diagnostic services as of the end of 2012.
  
  
  CONCLUSIONS
  As improved therapeutic options become available for people living with chronic hepatitis C, measures to support appropriate follow-up of people with suspected or confirmed chronic infections via primary care services will be required.
authors: Melbourne School of Population and Global Health, University of Melbourne, Victoria.
authors: Kathryn
authors: K
authors: Snow
authors: Centre for Population Health, Burnet Institute, Victoria.|Department of Epidemiology and Preventive Medicine, Monash University, Victoria.
authors: Nick
authors: N
authors: Scott
authors: Melbourne School of Population and Global Health, University of Melbourne, Victoria.
authors: Hazel J
authors: HJ
authors: Clothier
authors: WHO Collaborating Centre for Viral Hepatitis, Victorian Infectious Diseases Reference Laboratory, The Doherty Institute, Victoria.|Department of Medicine, University of Melbourne, Victoria.
authors: Jennifer H
authors: JH
authors: MacLachlan
authors: WHO Collaborating Centre for Viral Hepatitis, Victorian Infectious Diseases Reference Laboratory, The Doherty Institute, Victoria.|Department of Medicine, University of Melbourne, Victoria.
authors: Benjamin
authors: B
authors: Cowie
mesh_terms: D017677:Age Distribution; D003954:Diagnostic Services; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D018563:Disease Notification / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000175:diagnosis*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D014739:Victoria
chemical_list: D018937:Hepatitis C Antibodies
keywords: health services; hepatitis C; liver disease; mathematical model