Chronic hepatitis C infection in a rural medicaid HMO

James Calvert, Paula C. Goldenberg, Cathy Schock

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Context: Chronic hepatitis C infection (CHCI) is an increasingly common problem, affecting about 2% of the US population. The cost and complexity of treatment and difficulties in communicating with the infected population are of concern to insurers and health planners. Purpose: To describe the clinical features of patients with CHCI in a rural Medicaid-covered population and to describe a method developed for treating CHCI in an underserved rural community. Methods: We developed a disease management approach to patients with CHCI receiving insurance coverage through a Medicaid HMO in rural Oregon. A locally based multidisciplinary hepatitis committee was formed to develop a management protocol and a process for selecting patients for treatment. The committee met monthly to develop the treatment plan for individual patients. Day-to-day treatment was provided by a nurse under the supervision of the committee. Findings: One hundred forty-three adults with CHCI were identified by their primary care physicians. About half the patients had a type 1 genotype. Treatment with pegylated interferon and ribavirin was completed on 21 persons, 11 (52%) of whom had a virologic cure. Problems with treatment toxicity were common. Patient satisfaction with the treatment by the nurse was high. Conclusions: CHCI is common in this rural, nonminority Medicaid-insured population. A locally based disease management model was developed that was well received by patients and was successful in delivering a high quality of care for people with CHCI in a rural area.

Original languageEnglish (US)
Pages (from-to)74-78
Number of pages5
JournalJournal of Rural Health
Volume21
Issue number1
DOIs
StatePublished - Dec 2004

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Health Maintenance Organizations
Medicaid
Chronic Hepatitis C
contagious disease
Infection
Disease Management
Population
Therapeutics
Nurses
nurse
management
Insurance Carriers
Insurance Coverage
Disease
Quality of Health Care
Ribavirin
Primary Care Physicians
Rural Population
insurance coverage
Patient Satisfaction

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Chronic hepatitis C infection in a rural medicaid HMO. / Calvert, James; Goldenberg, Paula C.; Schock, Cathy.

In: Journal of Rural Health, Vol. 21, No. 1, 12.2004, p. 74-78.

Research output: Contribution to journalArticle

Calvert, James ; Goldenberg, Paula C. ; Schock, Cathy. / Chronic hepatitis C infection in a rural medicaid HMO. In: Journal of Rural Health. 2004 ; Vol. 21, No. 1. pp. 74-78.
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