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Learning Objective 1: The learner will be able to identify 3 components of an integrated health care model that promote patients' engagement and retention into care.
Learning Objective 2: The learner will be able to identify 3 factors that impact routine follow-up visit attendance.
Hepatitis C is a chronic illness that has significant co-morbidities associated with it. While it is widely recognized that persons with chronic hepatitis C (CHC) require routine liver care and treatment only a small number of patients receive treatment. Integrated care models have been shown to be successful in providing comprehensive care in numerous chronic illnesses; however there has been limited study on their benefit in CHC. The primary purpose of this study will be to evaluate the impact of an initial evaluation within the NP clinic of a faculty practice at an Academic Medical Center with integrated services on case management and retention into routine liver care. Since patients with CHC have high rates of substance abuse and psychiatric co-morbidities, an additional purpose of this study will be to evaluate the number of patients requiring psychiatric referral after completing a psycho-social assessment. This cohort study included a convenience sample of 35 subjects and utilized a retrospective chart review to determine if patients were more likely to engage into routine liver care if services were delivered within a NP clinic that provided integrated psychiatric and social services. Descriptive and comparative analysis was conducted in this study utilizing SAS 9.2. The study showed that of the 35 subjects that completed an initial pre-screening visit, greater than 50%, attended at least 1 follow-up visit. The study indentifies female gender as a possible positive factor on follow-up visit attendance. While the study was not able to positively identify factors that serve as potential barriers to care or unequivocally show that a NP clinic with integrated services improves patient engagement; it did demonstrate that a large proportion of patients who were not previously receiving care for CHC could be engaged to some degree into routine liver care.
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