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  1. Artikel ; Online: Association between claims-based setting of diagnosis and treatment initiation among Medicare patients with hepatitis C.

    Zhang, Hao / Bao, Yuhua / Hutchings, Kayla / Shapiro, Martin F / Kapadia, Shashi N

    Health services research

    2024  

    Abstract: Objective: To develop a claims-based algorithm to determine the setting of a disease diagnosis.: Data sources and study setting: Medicare enrollment and claims data from 2014 to 2019.: Study design: We developed a claims-based algorithm using ... ...

    Abstract Objective: To develop a claims-based algorithm to determine the setting of a disease diagnosis.
    Data sources and study setting: Medicare enrollment and claims data from 2014 to 2019.
    Study design: We developed a claims-based algorithm using facility indicators, revenue center codes, and place of service codes to identify settings where HCV diagnosis first appeared. When the first appearance was in a laboratory, we attempted to associate HCV diagnoses with subsequent clinical visits. Face validity was assessed by examining association of claims-based diagnostic settings with treatment initiation.
    Data collection/extraction methods: Patients newly diagnosed with HCV and continuously enrolled in traditional Medicare Parts A, B, and D (12 months before and 6 months after index diagnosis) were included.
    Principal findings: Among 104,454 patients aged 18-64 and 66,726 aged ≥65, 70.1% and 69%, respectively, were diagnosed in outpatient settings, and 20.2% and 22.7%, respectively in laboratory or unknown settings. Logistic regression revealed significantly lower odds of treatment initiation after diagnosis in emergency departments/urgent cares, hospitals, laboratories, or unclassified settings, than in outpatient visits.
    Conclusions: The algorithm identified the setting of HCV diagnosis in most cases, and found significant associations with treatment initiation, suggesting an approach that can be adapted for future claims-based studies.
    Sprache Englisch
    Erscheinungsdatum 2024-05-21
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 410435-3
    ISSN 1475-6773 ; 0017-9124
    ISSN (online) 1475-6773
    ISSN 0017-9124
    DOI 10.1111/1475-6773.14330
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Hepatitis C Treatment Initiation Among US Medicaid Enrollees.

    Kapadia, Shashi N / Zhang, Hao / Gonzalez, Christopher J / Sen, Bisakha / Franco, Ricardo / Hutchings, Kayla / Wethington, Elaine / Talal, Andrew / Lloyd, Audrey / Dharia, Arpan / Wells, Martin / Bao, Yuhua / Shapiro, Martin F

    JAMA network open

    2023  Band 6, Heft 8, Seite(n) e2327326

    Abstract: Importance: Direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection is highly effective but remains underused. Understanding disparities in the delivery of DAAs is important for HCV elimination planning and designing interventions ... ...

    Abstract Importance: Direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection is highly effective but remains underused. Understanding disparities in the delivery of DAAs is important for HCV elimination planning and designing interventions to promote equitable treatment.
    Objective: To examine variations in the receipt of DAA in the 6 months following a new HCV diagnosis.
    Design, setting, and participants: This retrospective cohort study used national Medicaid claims from 2017 to 2019 from 50 states, Washington DC, and Puerto Rico. Individuals aged 18 to 64 years with a new diagnosis of HCV in 2018 were included. A new diagnosis was defined as a claim for an HCV RNA test followed by an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis code, after a 1-year lookback period.
    Main outcomes and measures: Outcome was receipt of a DAA prescription within 6 months of diagnosis. Logistic regression was used to examine demographic factors and ICD-10-identified comorbidities associated with treatment initiation.
    Results: Among 87 652 individuals, 43 078 (49%) were females, 12 355 (14%) were age 18 to 29 years, 35 181 (40%) age 30 to 49, 51 282 (46%) were non-Hispanic White, and 48 840 (49%) had an injection drug use diagnosis. Of these individuals, 17 927 (20%) received DAAs within 6 months of their first HCV diagnosis. In the regression analyses, male sex was associated with increased treatment initiation (OR, 1.24; 95% CI, 1.16-1.33). Being age 18 to 29 years (OR, 0.65; 95% CI, 0.50-0.85) and injection drug use (OR, 0.84; 95% CI, 0.75-0.94) were associated with decreased treatment initiation. After adjustment for state fixed effects, Asian race (OR, 0.50; 95% CI, 0.40-0.64), American Indian or Alaska Native race (OR, 0.68; 95% CI, 0.55-0.84), and Hispanic ethnicity (OR, 0.81; 95% CI, 0.71-0.93) were associated with decreased treatment initiation. Adjustment for state Medicaid policy did not attenuate the racial or ethnic disparities.
    Conclusions: In this retrospective cohort study, HCV treatment initiation was low among Medicaid beneficiaries and varied by demographic characteristics and comorbidities. Interventions are needed to increase HCV treatment uptake among Medicaid beneficiaries and to address disparities in treatment among key populations, including younger individuals, females, individuals from minoritized racial and ethnic groups, and people who inject drugs.
    Mesh-Begriff(e) Female ; United States/epidemiology ; Humans ; Male ; Medicaid ; Antiviral Agents/therapeutic use ; Retrospective Studies ; Hepatitis C, Chronic/diagnosis ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Hepacivirus/genetics
    Chemische Substanzen Antiviral Agents
    Sprache Englisch
    Erscheinungsdatum 2023-08-01
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.27326
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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