Meeting vaccination quality measures for hepatitis A and B virus in patients with chronic hepatitis C infection.

[Guest guest]

Hepatology. 2011 Jan;53(1):42-52. doi: 10.1002/hep.24024. Epub 2010 Dec 13.

Meeting vaccination quality measures for hepatitis A and B virus in patients

with chronic hepatitis C infection.

Kramer JR, Hachem CY, Kanwal F, Mei M, El-Serag HB.

Houston VA Health Services Research #38; Development Center of Excellence,

E. DeBakey Veterans Affairs Medical Center, Houston, TX; Health Services

Research, Baylor College of Medicine, Houston, TX. jkramer@....

Abstract

Coinfection with hepatitis A virus (HAV) or hepatitis B virus (HBV) in patients

with chronic hepatitis C virus (HCV) is associated with increased morbidity and

mortality. The Center for Medicare and Medicaid Services has identified HAV and

HBV vaccination as a priority area for quality measurement in HCV. It is unclear

to what extent patients with HCV meet these recommendations. We used national

data from the Department of Veterans Affairs HCV Clinical Case Registry to

evaluate the prevalence and predictors of meeting the quality measure (QM) of

receiving vaccination or documented immunity to HAV and HBV in patients with

chronic HCV. We identified 88,456 patients who had overall vaccination rates of

21.9% and 20.7% for HBV and HAV, respectively. The QM rates were 57.0% and 45.5%

for HBV and HAV, respectively. Patients who were nonwhite or who had elevated

alanine aminotransferase levels, cirrhosis, or human immunodeficiency virus were

more likely to meet the HBV QM. Factors related to HCV care were also

determinants of meeting the HBV QM. These factors included receiving a

specialist consult, genotype testing, or HCV treatment. Patients who were older,

had psychosis, and had a higher comorbidity score were less likely to meet the

HBV QM. With a few exceptions, similar variables were related to meeting the HAV

QM. The incidence of superinfection with acute HBV and HAV was low, but it was

significantly lower in patients who received vaccination than in those who did

not. Conclusion: Quality measure rates for HAV and HBV are suboptimal for

patients with chronic HCV. In addition, several patient-related factors and

receiving HCV-related care are associated with a higher likelihood of meeting

QMs. (HEPATOLOGY 2011). American Association for the Study of

Liver Diseases.

PMID: 21254161 [PubMed - in process]

[Guest guest]

Hepatology. 2011 Jan;53(1):42-52. doi: 10.1002/hep.24024. Epub 2010 Dec 13.

Meeting vaccination quality measures for hepatitis A and B virus in patients

with chronic hepatitis C infection.

Kramer JR, Hachem CY, Kanwal F, Mei M, El-Serag HB.

Houston VA Health Services Research #38; Development Center of Excellence,

E. DeBakey Veterans Affairs Medical Center, Houston, TX; Health Services

Research, Baylor College of Medicine, Houston, TX. jkramer@....

Abstract

Coinfection with hepatitis A virus (HAV) or hepatitis B virus (HBV) in patients

with chronic hepatitis C virus (HCV) is associated with increased morbidity and

mortality. The Center for Medicare and Medicaid Services has identified HAV and

HBV vaccination as a priority area for quality measurement in HCV. It is unclear

to what extent patients with HCV meet these recommendations. We used national

data from the Department of Veterans Affairs HCV Clinical Case Registry to

evaluate the prevalence and predictors of meeting the quality measure (QM) of

receiving vaccination or documented immunity to HAV and HBV in patients with

chronic HCV. We identified 88,456 patients who had overall vaccination rates of

21.9% and 20.7% for HBV and HAV, respectively. The QM rates were 57.0% and 45.5%

for HBV and HAV, respectively. Patients who were nonwhite or who had elevated

alanine aminotransferase levels, cirrhosis, or human immunodeficiency virus were

more likely to meet the HBV QM. Factors related to HCV care were also

determinants of meeting the HBV QM. These factors included receiving a

specialist consult, genotype testing, or HCV treatment. Patients who were older,

had psychosis, and had a higher comorbidity score were less likely to meet the

HBV QM. With a few exceptions, similar variables were related to meeting the HAV

QM. The incidence of superinfection with acute HBV and HAV was low, but it was

significantly lower in patients who received vaccination than in those who did

not. Conclusion: Quality measure rates for HAV and HBV are suboptimal for

patients with chronic HCV. In addition, several patient-related factors and

receiving HCV-related care are associated with a higher likelihood of meeting

QMs. (HEPATOLOGY 2011). American Association for the Study of

Liver Diseases.

PMID: 21254161 [PubMed - in process]

[Guest guest]

Hepatology. 2011 Jan;53(1):42-52. doi: 10.1002/hep.24024. Epub 2010 Dec 13.

Meeting vaccination quality measures for hepatitis A and B virus in patients

with chronic hepatitis C infection.

Kramer JR, Hachem CY, Kanwal F, Mei M, El-Serag HB.

Houston VA Health Services Research #38; Development Center of Excellence,

E. DeBakey Veterans Affairs Medical Center, Houston, TX; Health Services

Research, Baylor College of Medicine, Houston, TX. jkramer@....

Abstract

Coinfection with hepatitis A virus (HAV) or hepatitis B virus (HBV) in patients

with chronic hepatitis C virus (HCV) is associated with increased morbidity and

mortality. The Center for Medicare and Medicaid Services has identified HAV and

HBV vaccination as a priority area for quality measurement in HCV. It is unclear

to what extent patients with HCV meet these recommendations. We used national

data from the Department of Veterans Affairs HCV Clinical Case Registry to

evaluate the prevalence and predictors of meeting the quality measure (QM) of

receiving vaccination or documented immunity to HAV and HBV in patients with

chronic HCV. We identified 88,456 patients who had overall vaccination rates of

21.9% and 20.7% for HBV and HAV, respectively. The QM rates were 57.0% and 45.5%

for HBV and HAV, respectively. Patients who were nonwhite or who had elevated

alanine aminotransferase levels, cirrhosis, or human immunodeficiency virus were

more likely to meet the HBV QM. Factors related to HCV care were also

determinants of meeting the HBV QM. These factors included receiving a

specialist consult, genotype testing, or HCV treatment. Patients who were older,

had psychosis, and had a higher comorbidity score were less likely to meet the

HBV QM. With a few exceptions, similar variables were related to meeting the HAV

QM. The incidence of superinfection with acute HBV and HAV was low, but it was

significantly lower in patients who received vaccination than in those who did

not. Conclusion: Quality measure rates for HAV and HBV are suboptimal for

patients with chronic HCV. In addition, several patient-related factors and

receiving HCV-related care are associated with a higher likelihood of meeting

QMs. (HEPATOLOGY 2011). American Association for the Study of

Liver Diseases.

PMID: 21254161 [PubMed - in process]

[Guest guest]

Hepatology. 2011 Jan;53(1):42-52. doi: 10.1002/hep.24024. Epub 2010 Dec 13.

Meeting vaccination quality measures for hepatitis A and B virus in patients

with chronic hepatitis C infection.

Kramer JR, Hachem CY, Kanwal F, Mei M, El-Serag HB.

Houston VA Health Services Research #38; Development Center of Excellence,

E. DeBakey Veterans Affairs Medical Center, Houston, TX; Health Services

Research, Baylor College of Medicine, Houston, TX. jkramer@....

Abstract

Coinfection with hepatitis A virus (HAV) or hepatitis B virus (HBV) in patients

with chronic hepatitis C virus (HCV) is associated with increased morbidity and

mortality. The Center for Medicare and Medicaid Services has identified HAV and

HBV vaccination as a priority area for quality measurement in HCV. It is unclear

to what extent patients with HCV meet these recommendations. We used national

data from the Department of Veterans Affairs HCV Clinical Case Registry to

evaluate the prevalence and predictors of meeting the quality measure (QM) of

receiving vaccination or documented immunity to HAV and HBV in patients with

chronic HCV. We identified 88,456 patients who had overall vaccination rates of

21.9% and 20.7% for HBV and HAV, respectively. The QM rates were 57.0% and 45.5%

for HBV and HAV, respectively. Patients who were nonwhite or who had elevated

alanine aminotransferase levels, cirrhosis, or human immunodeficiency virus were

more likely to meet the HBV QM. Factors related to HCV care were also

determinants of meeting the HBV QM. These factors included receiving a

specialist consult, genotype testing, or HCV treatment. Patients who were older,

had psychosis, and had a higher comorbidity score were less likely to meet the

HBV QM. With a few exceptions, similar variables were related to meeting the HAV

QM. The incidence of superinfection with acute HBV and HAV was low, but it was

significantly lower in patients who received vaccination than in those who did

not. Conclusion: Quality measure rates for HAV and HBV are suboptimal for

patients with chronic HCV. In addition, several patient-related factors and

receiving HCV-related care are associated with a higher likelihood of meeting

QMs. (HEPATOLOGY 2011). American Association for the Study of

Liver Diseases.

PMID: 21254161 [PubMed - in process]