ArticleCanadian liver journal2026
Trends in chronic hepatitis C visits by providers in Quebec, Canada: A population-level cohort study.
Article in Canadian liver journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Despite primary care's role in hepatitis C elimination, evidence of primary care providers' involvement remains limited. To enhance our knowledge of health care use among hepatitis C-infected individuals, we described trends in hepatitis-related visits and patients' characteristics by provider specialty in Quebec. Methods: We conducted a population-based cohort study using all hepatitis C cases in the Quebec Mandatory Reportable Disease database (1990-2018), linked with the provincial physician billing database. We described monthly rates of hepatitis-related medical visits using a generalized additive model across different provider specialties and stratified our results by at-risk populations. Results: Between 1990 and 2018, 37,251 patients were diagnosed with hepatitis C. Visit rates were lower for other specialties compared to gastroenterologists; rate ratios (RRs) were 0.73 (95% CI 0.67-0.79) for general practitioners/family physicians (GPs/FPs) and 0.24 (95% CI 0.21-0.26) for internal medicine physicians. The RR for GPs/FPs was 1.21(95% CI 1.05-1.39) among people who inject drugs (PWID), 0.76 (95% CI 0.71-0.82) among the 1945-1975 birth cohort, and 0.37 (95% CI 0.28-0.49) among immigrants, compared to gastroenterologists. Patients seen primarily by GPs/FPs were more likely to have a history of drug use and mental health disorders than those seen by specialists. Conclusions: Hepatitis C cases were more likely to be seen by gastroenterologists than by GPs/FPs in Quebec from 1990 to 2018. However, GPs/FPs had higher visit rates for PWID. Specialists more often managed immigrants and the 1945-1975 cohort. These findings suggest disparities in care access and emphasize GPs/FPs' role in managing hepatitis C among marginalized populations.
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