Differences In Hepatitis B Screening And Diagnosis Among Practices Serving Asian And Non-Asian Patients Using Electronic Health Records

Author

Ha Vo, Yale UniversityFollow

Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Xiaomei Ma

Abstract

Background: Racial disparity in chronic infection with hepatitis B virus is a major public health issue in the United States. Limited data exist on rates of screening and diagnosis collected from providers instead of patient self-reported surveys.

Methods: Data were extracted from electronic health records (EHRs) of practices in New York City for 2013. Three measures of hepatitis B (Hep B) screening and diagnosis were collected: 1) lab tests for hepatitis B virus surface antigen (HBsAg); 2) diagnosis via International Classification of Diseases, 9th edition (ICD-9) codes; and 3) of lab tests ordered, positive results. Generalized estimating equation models were used to analyze predictors of Hep B screening and diagnosis across three patient groups: Asians who preferred Chinese, Asians who preferred English, and non-Asian patients.

Results: The study population consisted of 377 practices, with an average of 20% (SD = 33%) Asian patients per practice. On average, 5% (SD = 10%), 0.2% (SD = 0.7%), and 1% (SD = 5%) of patients in a practice were screened, diagnosed, and HBsAg positive respectively. Chinese-preferred Asians were significantly more likely to undergo screening compared to English-preferred Asians (beta=0.97, p-value <.01) or non-Asians (beta = 0.89, p-value <.01). They were also more likely to be diagnosed compared to English-preferred Asians (beta = 1.78, p-value <.01) or non-Asians (beta = 2.96, p-value <.01).

Discussion: Practices were significantly more likely to screen for and make diagnosis of Hep B among Asian sub-groups, but rates remain low. This indicates a need for educational interventions targeting providers or by integrating Hep B quality metrics in EHRs. This analysis of 2013 data provided a baseline estimate of health care delivery patterns of Hep B of a hard-to-reach and high-risk population prior to screening recommendation changes in 2014.

Comments

This is an Open Access Thesis.

Recommended Citation

Vo, Ha, "Differences In Hepatitis B Screening And Diagnosis Among Practices Serving Asian And Non-Asian Patients Using Electronic Health Records" (2015). Public Health Theses. 1304.
https://elischolar.library.yale.edu/ysphtdl/1304