Leave No-One Behind: A Retrospective Study of Hepatitis C Testing and Linkage to Care for Hospital Inpatients
2. Materials and Methods
2.1. Study Setting and Population
2.2. Study Design
- Had a separation with hepatitis C coding;
- Had hepatitis C virus (HCV) antibody testing (among those with hepatitis C coding) linked to admission, see below;
- Had HCV RNA testing (among those who were HCV antibody positive);
- Had evidence of treatment (among those who were HCV RNA positive and among those who had hepatitis C coding).
- The estimated number of people living with hepatitis C in the hospital catchment area.
- An estimate of the number of missed opportunities in primary outcomes 2–4.
2.3. Data Analysis
3.1. Patient Summary
3.2. Hepatitis C Care Cascade
3.3. Identifying Missed Opportunities
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Episode||Inpatient admission or attendance to emergency department (ED)|
|Separation coding||The diagnosis coding according to the International Classification of Diseases, Tenth revision (ICD-10)  as per the medical information included in the patients discharge/ED summary|
|Hepatitis C exposure||A positive HCV antibody test or hepatitis C separation coding|
|Diagnosis of hepatitis C||A positive HCV RNA test|
|Evidence of treatment||A prescription for DAAs dispensed at the Alfred Hospital pharmacy|
|Episode specialty||Admission ward|
|Hepatitis specialty units||Infectious disease and gastroenterology|
|Mental health||All psychiatric wards|
|Surgical||All general and specialist surgical units.|
|Emergency||Emergency department and trauma unit|
|General medicine||All general medicine wards|
|Other medical specialty||All non-surgical specialty wards|
|Hepatitis C ICD-10 codes ||Acute hepatitis C (B171)|
Chronic viral hepatitis C (B182)
Chronic viral hepatitis
Unspecified viral hepatitis without hepatic coma (B199)
|Hospital catchment area ||The combination of the following statistical area 3 (SA3) regions:|
|Unit||Admissions (n = 4901)||Unique |
Patients (n = 2149 *)
|Antibody Testing, n (% of Patients)||Antibody Positive, n (% of Antibody |
|RNA Testing, n (% of Antibody Positive)||RNA Positive, n (% of RNA Testing)||Treatment, |
n (% of Ab Positive)
n (% of RNA Positive)
|Treatment, n (% of Unique Patients)|
|Hepatitis Specialist||1159 (23.6%)||576 (26.8%)||92 (16%)||88 (95.7%)||39 (44.3%)||11 (28.2%)||7 (8%)||2 (18.2%)||74 (12.9%)|
|Emergency||1075 (22%)||738 (34.3%)||101 (13.7%)||94 (93.1%)||32 (34.1%)||15 (46.9%)||5 (5.3%)||2 (13.3%)||61 (8.3%)|
|Surgical||592 (12.1%)||455 (21.2%)||73 (16%)||71 (97.3%)||22 (31%)||6 (27.3%)||7 (9.9%)||1 (16.7%)||41 (9%)|
|General Medicine||469 (9.6%)||294 (13.7%)||60 (20.4%)||59 (98.3%)||15 (25.4%)||4 (26.7%)||6 (10.2%)||0||32 (10.9%)|
|Mental Health||477 (9.7%)||276 (12.8%)||70 (25.4%)||69 (98.6%)||22 (31.9%)||8 (36.4%)||3 (4.3%)||0||39 (14.1%)|
|1129 (23%)||640 (29.8%)||100 (15.7%)||95 (96%)||32 (35.7%)||13 (40.6%)||11 (11.6%)||2 (15.4%)||68 (10.6%)|
|OR||95% CI||aOR||95% CI|
|Other medical specialties||1.05||0.66–1.67||0.51||0.13–1.98|
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Roder, C.; Cosgrave, C.; Mackie, K.; Roberts, S.K.; Hellard, M.E.; Wade, A.J.; Doyle, J.S. Leave No-One Behind: A Retrospective Study of Hepatitis C Testing and Linkage to Care for Hospital Inpatients. Viruses 2023, 15, 913. https://doi.org/10.3390/v15040913
Roder C, Cosgrave C, Mackie K, Roberts SK, Hellard ME, Wade AJ, Doyle JS. Leave No-One Behind: A Retrospective Study of Hepatitis C Testing and Linkage to Care for Hospital Inpatients. Viruses. 2023; 15(4):913. https://doi.org/10.3390/v15040913Chicago/Turabian Style
Roder, Christine, Carl Cosgrave, Kathryn Mackie, Stuart K. Roberts, Margaret E. Hellard, Amanda J. Wade, and Joseph S. Doyle. 2023. "Leave No-One Behind: A Retrospective Study of Hepatitis C Testing and Linkage to Care for Hospital Inpatients" Viruses 15, no. 4: 913. https://doi.org/10.3390/v15040913