A Telementoring Program and Hepatitis C Virus Care in Rural Patients

Authors

Ping Du, Departments of Medicine, and Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
Xin Yin, Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
Lan Kong, Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
Jeah Jung, Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA

Document Type

Article

Publication Date

3-12-2021

Abstract

Background: Rural patients with chronic hepatitis C virus (HCV) infection may be less likely to access HCV care than those in urban areas. A telementoring, task-shifting model has been implemented to address the unmet needs of HCV care. Evidence is needed on whether this intervention improves HCV care in rural HCV patients.

Methods: We compared three key HCV care indicators among Medicare patients with chronic hepatitis C in 2014–2016 by urban–rural status between New Mexico with a telementoring program and Pennsylvania without such a program. We classified each patient’s urban–rural status based on his or her ZIP code of residence. We used multivariable log-binomial regressions to examine the relative probability of receiving HCV care by urban and rural status in two states.

Results: In New Mexico, 41.3% of HCV patients resided in rural areas (N = 1155). In Pennsylvania, rural patients accounted for 13.2% (N = 1775). The unadjusted overall rates of receiving HCV RNA or genotype testing within 12 months before HCV treatment were 76.1% in ‘‘rural-New Mexico’’ versus 73.3% in ‘‘rural-Pennsylvania,’’ 66.2% in ‘‘urban-New Mexico,’’ and 70.2% in ‘‘urban-Pennsylvania.’’ Post-treatment HCV RNA testing rate was also high in ‘‘rural-New Mexico’’ (83.0%). After adjusting for demographic and clinical characteristics, ‘‘rural-New Mexico’’ HCV patients who received HCV treatment still had the highest probability of taking HCV RNA or genotype testing before HCV treatment, compared with other groups (relative risk [95% confidence interval]: 0.91 [0.84–1.00] in ‘‘rural-Pennsylvania,’’ 0.85 [0.78–0.93] in ‘‘urban-New Mexico,’’ and 0.93 [0.87–1.00] in ‘‘urban-Pennsylvania’’).

Conclusions: The telementoring program may help improve HCV care in rural patients.

Recommended Citation

Du, P., Yin, X., Kong, L., & Jung, J. A telementoring program and hepatitis C virus care in rural patients. Telemedicine Reports. 2021; 2 (1), 143-147. Available at: https://www.liebertpub.com/doi/pdf/10.1089/tmr.2021.0001.