Racial Disparities in Treatment Rates for Chronic Hepatitis C: Analysis of a Population-Based Cohort of 73,665 Patients in the United States
Chronic hepatitis C (CHC) disproportionately affects racial minorities in the United States (US). Although prior studies have reported lower treatment rates in Blacks than in Caucasians, the rates of other minorities remain understudied. We aimed to examine antiviral treatment rates by race and to e...
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| Veröffentlicht in: | Medicine (Baltimore) 2016-05, Vol.95 (22), p.e3719-e3719 |
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| creator | Vutien, Philip Hoang, Joseph Brooks, Louis Nguyen, Nghia H. Nguyen, Mindie H. |
| description | Chronic hepatitis C (CHC) disproportionately affects racial minorities in the United States (US). Although prior studies have reported lower treatment rates in Blacks than in Caucasians, the rates of other minorities remain understudied. We aimed to examine antiviral treatment rates by race and to evaluate the effect of other demographic, medical, and psychiatric factors on treatment rates. We performed a population-based study of adult CHC patients identified via ICD-9CM query from OptumInsight's Data Mart from January 2009 to December 2013. Antiviral treatment was defined by pharmaceutical claims for interferon and/or pegylated-interferon. A total of 73,665 insured patients were included: 51,282 Caucasians, 10,493 Blacks, 8679 Hispanics, and 3211 Asians. Caucasians had the highest treatment rate (10.7%) followed by Blacks (8.8%), Hispanics (8.8%), and Asians (7.9%, P |
| doi_str_mv | 10.1097/MD.0000000000003719 |
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Although prior studies have reported lower treatment rates in Blacks than in Caucasians, the rates of other minorities remain understudied. We aimed to examine antiviral treatment rates by race and to evaluate the effect of other demographic, medical, and psychiatric factors on treatment rates. We performed a population-based study of adult CHC patients identified via ICD-9CM query from OptumInsight's Data Mart from January 2009 to December 2013. Antiviral treatment was defined by pharmaceutical claims for interferon and/or pegylated-interferon. A total of 73,665 insured patients were included: 51,282 Caucasians, 10,493 Blacks, 8679 Hispanics, and 3211 Asians. Caucasians had the highest treatment rate (10.7%) followed by Blacks (8.8%), Hispanics (8.8%), and Asians (7.9%, P < .001). Hispanics had the highest cirrhosis rates compared with Caucasians, Blacks, and Asians (20.7% vs 18.3%, 17.1%, and 14.3%, respectively). Caucasians were the most likely to have a psychiatric comorbidity (20.1%) and Blacks the most likely to have a medical comorbidity (44%). Asians were the least likely to have a psychiatric (6.4%) or medical comorbidity (26.9%). On multivariate analysis, racial minority was a significant predictor of nontreatment with odds ratios of 0.82 [confidence interval (CI): 0.74-0.90] for Blacks, 0.87 (CI: 0.78-0.96) for Hispanics, and 0.73 (CI: 0.62-0.86) for Asians versus Caucasians. Racial minorities had lower treatment rates than Caucasians. Despite fewer medical and psychiatric comorbidities and higher incomes and educational levels, Asians had the lowest treatment rates. Hispanics also had lower treatment rates than Caucasians despite having higher rates of cirrhosis. Future studies should aim to identify underlying racial-related barriers to hepatitis C virus treatment besides socioeconomic status and medical or psychiatric comorbidities.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000003719</identifier><identifier>PMID: 27258498</identifier><language>eng</language><publisher>United States: The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Continental Population Groups ; Female ; Hepatitis C, Chronic - ethnology ; Humans ; Male ; Middle Aged ; Morbidity - trends ; Observational Study ; Population Surveillance - methods ; Retrospective Studies ; United States - epidemiology</subject><ispartof>Medicine (Baltimore), 2016-05, Vol.95 (22), p.e3719-e3719</ispartof><rights>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3552-5dd77134661b3eb8e306531f9fe7235e3bd3790a65820c714acad0d555045de73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900706/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900706/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27258498$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vutien, Philip</creatorcontrib><creatorcontrib>Hoang, Joseph</creatorcontrib><creatorcontrib>Brooks, Louis</creatorcontrib><creatorcontrib>Nguyen, Nghia H.</creatorcontrib><creatorcontrib>Nguyen, Mindie H.</creatorcontrib><title>Racial Disparities in Treatment Rates for Chronic Hepatitis C: Analysis of a Population-Based Cohort of 73,665 Patients in the United States</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Chronic hepatitis C (CHC) disproportionately affects racial minorities in the United States (US). Although prior studies have reported lower treatment rates in Blacks than in Caucasians, the rates of other minorities remain understudied. We aimed to examine antiviral treatment rates by race and to evaluate the effect of other demographic, medical, and psychiatric factors on treatment rates. We performed a population-based study of adult CHC patients identified via ICD-9CM query from OptumInsight's Data Mart from January 2009 to December 2013. Antiviral treatment was defined by pharmaceutical claims for interferon and/or pegylated-interferon. A total of 73,665 insured patients were included: 51,282 Caucasians, 10,493 Blacks, 8679 Hispanics, and 3211 Asians. Caucasians had the highest treatment rate (10.7%) followed by Blacks (8.8%), Hispanics (8.8%), and Asians (7.9%, P < .001). Hispanics had the highest cirrhosis rates compared with Caucasians, Blacks, and Asians (20.7% vs 18.3%, 17.1%, and 14.3%, respectively). Caucasians were the most likely to have a psychiatric comorbidity (20.1%) and Blacks the most likely to have a medical comorbidity (44%). Asians were the least likely to have a psychiatric (6.4%) or medical comorbidity (26.9%). On multivariate analysis, racial minority was a significant predictor of nontreatment with odds ratios of 0.82 [confidence interval (CI): 0.74-0.90] for Blacks, 0.87 (CI: 0.78-0.96) for Hispanics, and 0.73 (CI: 0.62-0.86) for Asians versus Caucasians. Racial minorities had lower treatment rates than Caucasians. Despite fewer medical and psychiatric comorbidities and higher incomes and educational levels, Asians had the lowest treatment rates. Hispanics also had lower treatment rates than Caucasians despite having higher rates of cirrhosis. Future studies should aim to identify underlying racial-related barriers to hepatitis C virus treatment besides socioeconomic status and medical or psychiatric comorbidities.</description><subject>Adult</subject><subject>Continental Population Groups</subject><subject>Female</subject><subject>Hepatitis C, Chronic - ethnology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity - trends</subject><subject>Observational Study</subject><subject>Population Surveillance - methods</subject><subject>Retrospective Studies</subject><subject>United States - epidemiology</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkd1u1DAQhS0EotvCEyAhX3JByvg_5gKpZIEitaIq7bXlTRxiyMap7W3Vd-Ch8XZLVfCNrTnfnDPyIPSKwCEBrd6dLg_h0WGK6CdoQQSTldCSP0ULACoqpRXfQ_sp_QQgTFH-HO1RRUXNdb1Av89t6-2Ilz7NNvrsXcJ-whfR2bx2U8bnNpdSHyJuhhgm3-JjN9tcyISb9_hosuNtKu_QY4vPwrwZixim6qNNrsNNGELMW1Gxt1IKfFbUYnsXkgeHLyefC_c9b2NeoGe9HZN7eX8foMvPny6a4-rk25evzdFJ1TIhaCW6TinCuJRkxdyqdgykYKTXvVOUCcdWHVMarBQ1hVYRblvbQSeEAC46p9gB-rDznTertevaMlC0o5mjX9t4a4L15l9l8oP5Ea4N1wAKZDF4c28Qw9XGpWzWPrVuHO3kwiYZojTTwGvgBWU7tI0hpej6hxgCZrtHc7o0_--xdL1-POFDz9_FFYDvgJswZhfTr3Fz46IZnB3zcOcnlKYVBSKh_A1UpUIo-wPx_ag4</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Vutien, Philip</creator><creator>Hoang, Joseph</creator><creator>Brooks, Louis</creator><creator>Nguyen, Nghia H.</creator><creator>Nguyen, Mindie H.</creator><general>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160501</creationdate><title>Racial Disparities in Treatment Rates for Chronic Hepatitis C: Analysis of a Population-Based Cohort of 73,665 Patients in the United States</title><author>Vutien, Philip ; Hoang, Joseph ; Brooks, Louis ; Nguyen, Nghia H. ; Nguyen, Mindie H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3552-5dd77134661b3eb8e306531f9fe7235e3bd3790a65820c714acad0d555045de73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Continental Population Groups</topic><topic>Female</topic><topic>Hepatitis C, Chronic - ethnology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity - trends</topic><topic>Observational Study</topic><topic>Population Surveillance - methods</topic><topic>Retrospective Studies</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vutien, Philip</creatorcontrib><creatorcontrib>Hoang, Joseph</creatorcontrib><creatorcontrib>Brooks, Louis</creatorcontrib><creatorcontrib>Nguyen, Nghia H.</creatorcontrib><creatorcontrib>Nguyen, Mindie H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vutien, Philip</au><au>Hoang, Joseph</au><au>Brooks, Louis</au><au>Nguyen, Nghia H.</au><au>Nguyen, Mindie H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial Disparities in Treatment Rates for Chronic Hepatitis C: Analysis of a Population-Based Cohort of 73,665 Patients in the United States</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>95</volume><issue>22</issue><spage>e3719</spage><epage>e3719</epage><pages>e3719-e3719</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>Chronic hepatitis C (CHC) disproportionately affects racial minorities in the United States (US). Although prior studies have reported lower treatment rates in Blacks than in Caucasians, the rates of other minorities remain understudied. We aimed to examine antiviral treatment rates by race and to evaluate the effect of other demographic, medical, and psychiatric factors on treatment rates. We performed a population-based study of adult CHC patients identified via ICD-9CM query from OptumInsight's Data Mart from January 2009 to December 2013. Antiviral treatment was defined by pharmaceutical claims for interferon and/or pegylated-interferon. A total of 73,665 insured patients were included: 51,282 Caucasians, 10,493 Blacks, 8679 Hispanics, and 3211 Asians. Caucasians had the highest treatment rate (10.7%) followed by Blacks (8.8%), Hispanics (8.8%), and Asians (7.9%, P < .001). Hispanics had the highest cirrhosis rates compared with Caucasians, Blacks, and Asians (20.7% vs 18.3%, 17.1%, and 14.3%, respectively). Caucasians were the most likely to have a psychiatric comorbidity (20.1%) and Blacks the most likely to have a medical comorbidity (44%). Asians were the least likely to have a psychiatric (6.4%) or medical comorbidity (26.9%). On multivariate analysis, racial minority was a significant predictor of nontreatment with odds ratios of 0.82 [confidence interval (CI): 0.74-0.90] for Blacks, 0.87 (CI: 0.78-0.96) for Hispanics, and 0.73 (CI: 0.62-0.86) for Asians versus Caucasians. Racial minorities had lower treatment rates than Caucasians. Despite fewer medical and psychiatric comorbidities and higher incomes and educational levels, Asians had the lowest treatment rates. Hispanics also had lower treatment rates than Caucasians despite having higher rates of cirrhosis. Future studies should aim to identify underlying racial-related barriers to hepatitis C virus treatment besides socioeconomic status and medical or psychiatric comorbidities.</abstract><cop>United States</cop><pub>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27258498</pmid><doi>10.1097/MD.0000000000003719</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Continental Population Groups Female Hepatitis C, Chronic - ethnology Humans Male Middle Aged Morbidity - trends Observational Study Population Surveillance - methods Retrospective Studies United States - epidemiology |
| title | Racial Disparities in Treatment Rates for Chronic Hepatitis C: Analysis of a Population-Based Cohort of 73,665 Patients in the United States |
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