PIN4 IMPACT OF CHRONIC HEPATITIS B IN THE BRAZILIAN HEALTH SYSTEM ACCORDING WITH DATA FROM DATASUS (ADMINISTRATIVE DATABASE) FROM MINISTRY OF HEALTH

Background The complexity of the hepatitis B natural history and its prevalence in specific populations in Australia challenges the capacity of the health system to deliver health care effectively to affected people. This study explores the challenges in delivering health care to people with chronic hepatitis B (CHB) in Australia. Methods: We conducted a grounded theory based qualitative study in which data were gathered from 70 in-depth interviews with government program officers, clinicians and health and community workers across Australia, and four focus group discussions with 40 health and community workers from the communities most at risk of CHB. Results: A systematic approach to screening populations at risk, including people born in countries with intermediate or high prevalence of CHB; consensus on clinical guidelines; development of a shared care framework for CHB involving general practitioners; and effective communication between patients and health professionals were identified as essential. Workforce development, particularly for primary health care professionals, and developing the knowledge and capacity of health professionals to communicate effectively with people with HBV were described as other major factors in reducing the barriers to CHB treatment in Australia. Conclusion: To improve the clinical management of people with CHB in Australia, the health system needs to encourage the screening of people at risk, improve access to clinical services, and the knowledge and communication skills of primary health care and community health service providers. This study supported developing a shared care model and related infrastructures including training programs, referral pathways and clinical guidelines.

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P680 A NATIONAL HEALTH SYSTEM RESPONSE TO CHRONIC HEPATITIS B: USING POPULATION DATA TO DEFINE GAPS IN CLINICAL CARE PROVISION

Journal of Hepatology ◽

10.1016/s0168-8278(14)60842-4 ◽

2014 ◽

Vol 60 (1) ◽

pp. S295-S296 ◽

Cited By ~ 2

Author(s):

N. Allard ◽

J.H. MacLachlan ◽

B. Cowie

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Health System ◽

Chronic Hepatitis B ◽

National Health ◽

Clinical Care ◽

National Health System ◽

Population Data ◽

System Response ◽

Care Provision

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Trends in Diagnosed Chronic Hepatitis B in a US Health System Population, 2006–2015

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz286 ◽

2019 ◽

Vol 6 (7) ◽

Author(s):

Mei Lu ◽

Yueren Zhou ◽

Scott D Holmberg ◽

Anne C Moorman ◽

Philip R Spradling ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Health System ◽

Chronic Hepatitis B ◽

Asian American ◽

Clinical Care ◽

The United States ◽

Rate Ratios ◽

Join Point ◽

Male To Female

Abstract Background Trends in the epidemiology of chronic hepatitis B (CHB) among routine clinical care patients in the United States are not well documented. We used data from the Chronic Hepatitis Cohort Study to investigate changes in prevalence and newly recorded cases of CHB from 2006 to 2015. Methods Annual percentage changes (APCs) were estimated using join point Poisson regression. Analyses were adjusted by study site; when an interaction with the trend was observed, APCs were estimated by subgroups. Differences in rates based on race, age, and sex were calculated with rate ratios. Results We identified 5492 patients with CHB within select health systems with total populations that ranged from 1.9 to 2.4 million persons. From 2006 to 2014, the prevalence of diagnosed CHB increased from 181.3 to 253.0 per 100 000 persons in the health system population; from 2014 to 2015, it declined to 237.0 per 100 000 persons. APC was +3.7%/y through 131 December 2014 (P < .001) and −15.0%/y (P < .001) thereafter. The rate of newly reported cases of CHB did not change significantly across the study period (APC, −1.1%/y; P = .07). The rates of newly reported cases were 20.5 times higher among patients in the Asian American/American Indian/Pacific Islander (ASINPI) category, compared with white patients, and 2.8 times higher among African American patients. The ratio of male to female patients was roughly 3:2. Conclusions The prevalence of diagnosed CHB in this US patient population increased from 2006 to 2014, after which it decreased significantly. Rates declined most rapidly among patients ≤40 or 61–70 years old, as well as among ASINPI patients. The rate of newly reported cases remained steady over the study period.

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