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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.113225v1 98/5/846    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Rousseau, C. M. Articles by Dominitz, J. A. PubMed PubMed Citation Articles by Rousseau, C. M. Articles by Dominitz, J. A. Related Collections Epidemiology Health Care Facilities/Services Access to Care Hepatitis African Americans/Blacks Government

Christine M. Rousseau, PhD, George N. Ioannou, MD, Jeffrey A. Todd-Stenberg, BA, Kevin L. Sloan, MD, Meaghan F. Larson, MPH, Christopher W. Forsberg, BA and Jason A. Dominitz, MD, MHS

At the time of the study, Christine M. Rousseau was with the Northwest Health Services Research and Development Center of Excellence and the Northwest Hepatitis C Resource Center, VA Puget Sound Health Care System, Seattle, WA. George N. Ioannou is with the Northwest Hepatitis C Resource Center and the Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, and the Department of Medicine, University of Washington School of Medicine, Seattle. Kevin L. Sloan is with the Epidemiologic Research and Information Center and the Northwest Hepatitis C Resource Center, VA Puget Sound Health Care System, Seattle, and the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle. Jeffrey A. Todd-Stenberg is with the Northwest Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle. Meaghan F. Larson is with the Northwest Hepatitis C Resource Center, VA Puget Sound Health Care System, Seattle. Christopher W. Forsberg is with the Northwest Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, and the Department of Biostatistics, University of Washington School of Public Health and Community Medicine, Seattle. Jason A. Dominitz is with the Northwest Hepatitis C Resource Center and the Epidemio-logic Research and Information Center, VA Puget Sound Health Care System, Seattle, and the Department of Medicine, University of Washington School of Medicine, Seattle.

Correspondence: Requests for reprints should be sent to Christine Rousseau, PhD, Box 358070, 1959 NE Pacific St, Seattle WA 98195-8070 (e-mail: cmr{at}u.washington.edu).

Objectives. We examined the association between race and hepatitis C virus (HCV) evaluation and treatment of veterans in the Northwest Network of the Department of Veterans Affairs (VA).

Methods. In our retrospective cohort study, we used medical records to determine antiviral treatment of 4263 HCV-infected patients from 8 VA medical centers. Secondary outcomes included specialty referrals, laboratory evaluation, viral genotype testing, and liver biopsy. Multiple logistic regression was used to adjust for clinical (measured through laboratory results and International Classification of Diseases, Ninth Revision, codes) and sociodemographic factors.

Results. Blacks were less than half as likely as Whites to receive antiviral treatment (odds ratio [OR]=0.38; 95% confidence interval [CI]=0.23, 0.63). Both had similar odds of referral and liver biopsy. However, Blacks were significantly less likely to have complete laboratory evaluation (OR=0.67; 95% CI=0.52, 0.88) and viral genotype testing (OR=0.68; 95% CI=0.51, 0.90).

Conclusions. Race is associated with receipt of medical care for various medical conditions. Further investigation is warranted to help understand whether patient preference or provider bias may explain why HCV-infected Blacks were less likely to receive medical care than Whites.