Evidence map›Paper›PMID 23934366›Full record

Observational studyDigestive diseases and sciences2014

Association between facility characteristics and the process of care delivered to patients with hepatitis C virus infection.

Fasiha Kanwal, Tuyen Hoang, Timothy Chrusciel, Jennifer R Kramer, Hashem B El-Serag, Janet Durfee, Jason A Dominitz, Elizabeth M Yano, Steven M Asch

Abstract readComparative StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Digestive diseases and sciences, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Fasiha KanwalHouston VA HSR&D Center of Excellence, Health Services Research and Development Service, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX, 77030, USA, fasiha.kanwal@va.gov.
Tuyen Hoang
Timothy Chrusciel
Jennifer R Kramer
Hashem B El-Serag
Janet Durfee
Jason A Dominitz
Elizabeth M Yano
Steven M Asch

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAvailable data suggest problems in the process of care provided to patients with chronic hepatitis C (HCV). However, the solutions to these problems are less obvious. Healthcare facility factors are potentially modifiable and may enhance process quality in HCV treatment.

methodsWe evaluated the relationship between the process of HCV care and facility factors including number of weekly half-day HCV clinics per 1,000 HCV patients, HCV-specific quality-improvement initiatives, and administrative service of the HCV clinic (gastroenterology, infectious disease, primary care) for a cohort of 34,258 patients who sought care in 126 Veterans Affairs facilities during 2003-2006. We measured HCV care on the basis of 23 HCV-specific process measures capturing pretreatment (seven measures), preventive and/or comorbid (seven measures), and treatment and treatment monitoring care (nine measures).

resultsPatients seen at a facility with >8 half-day clinics were 52 % more likely to receive overall indicated care (OR 1.52, 95 % CI 1.13-2.05). Patients seen at a facility with >3 HCV quality improvement initiatives were more likely to receive better preventive and/or comorbid care (OR 1.32, 95 % CI 1.00-1.74). Compared with patients in facilities with no dedicated HCV clinic, patients at facilities with gastroenterology-based clinics received better pretreatment care (OR 1.36, 95 % CI 1.01-1.85) and more antiviral treatment (OR 1.45, 95 % CI 1.06-1.97) whereas those at facilities with infectious disease-based or primary care-based clinics received better preventive and/or comorbid care (OR 1.59, 95 % CI 1.06-2.39 and 1.84, 95 % CI 1.21-2.79 respectively).

conclusionSeveral facility factors affected the process of HCV care. These factors may serve as targets for quality-improvement efforts.

Indexed as

Ambulatory Care FacilitiesDelivery of Health CareGastroenterologyInfectious Disease MedicineOutcome and Process Assessment, Health CarePrimary Health CareQuality of Health CareAntiviral AgentsAppointments and SchedulesComorbidityFemaleHepatitis C, ChronicHumansLinear ModelsLogistic ModelsMaleAntiviral Agents

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.