Clinicians need to do a better job of linking patients who test positive for hepatitis C virus (HCV) to medical care for the virus. Although primary care physicians (PCPs) and ob-gyns are the specialties most commonly ordering HCV tests, they fall short in linking patients with the virus to care compared with gastroenterologists and clinicians working in hospital settings.
Researchers analyzed medical claims data from Optum Clinformatics Data Mart, which provided information about the type of clinician ordering HCV tests, whether an individual tested positive for the virus and whether that person was linked to medical care for hep C.
Findings were presented at the 52nd International Liver Congress in Paris.
Out of 1.06 million people tested for hep C between 2010 and 2016, PCPs ordered 29.7 of the tests, ob-gyns ordered 19.1 percent and nurses and physician assistants ordered 5.3 percent. The average proportion of tests that came back positive, broken down by the specialty of the clinicians who ordered the tests, was 3 percent—higher than the national prevalence of hep C positivity of 1.7 percent.
Gastroenterologists, oncologists and infectious disease specialists each ordered less than 3 percent of the total tests in the sample. However, each of these specialties had the highest rate of positive tests, between 3.9 percent and 5.3 percent.
Overall, 13.8 percent of those who tested positive for HCV were linked to care for the virus. Those clinicians who practiced in a hospital setting and gastroenterologists had the highest rate of linking their HCV-positive patients to care, between 19.9 percent and 25 percent.
Among the three specialties that accounted for the largest proportion of tests ordered, ob-gyns had the lowest rate of linking their HCV-positive patients to care, at 4.7 percent.
The study authors’ statistical analysis indicated that compared with being screened for HCV by a PCP, being screened by a gastroenterologist significantly increased the likelihood of being treated for the virus.