Application of the health care system to First Nations and non-First Nations patients with chronic hepatitis C.

摘要

Approximately 240,000-300,000 persons are infected with hepatitis C virus (HCV) in Canada. However, there are no data on hepatitis C incidence, clinical features and management in Canadian First Nations (FN). The present study examines the incidence and demographics of HCV in FN and non-First Nations (non-FN) persons and evaluates how HCV-infected Manitobans in these two subpopulations use the health care.;Methods: Multiple administrative and public health databases were linked to develop a comprehensive Hepatitis C Research Database. Between 1/1/1991 and 31/12/2002, 5018 HCV-positive Manitoba residents were identified. The demographically-matched population control cohort was drawn from the Population Registry. Demographic and clinical information, hospital separations, physician office visits, prescription drugs use, etc. were compared between FN and non-FN persons with HC as well as between HCV and non-HCV cohorts.;Results: FN persons with HC were more often female and younger than non-FN HCV-infected persons. While risk factors for the progression of HC to cirrhosis were doubled in the FN group, decompensated disease and mortality were the same in both groups. FN persons with HC had higher rates of health care use overall (hospital and ambulatory care), but lower rates of liver disease-related health care use compared to non-FN persons with HC. Finally, FN patients received antiviral treatment less often than non-FN patients.;Conclusions: The results of this study confirm that the rates of HC are higher among FN compared to non-FN persons yet liver disease-related care was less frequent among this group despite similarities in clinical features. Persons with HC used more health care compared to non-infected Manitobans. The created database facilitates designing subsequent projects to further examine HCV in Manitoba, to forecast the future burden of the disease, and to formulate specific health programmes of prevention and care.;Objectives: 1. To describe the incidence of hepatitis C (HC) by comparing rates and demographics of HCV infection in FN and non-FN populations. 2. To compare the clinical features between HCV-infected FN and non-FN individuals. 3. To compare health care resources utilization (1) between FN and non-FN individuals with hepatitis C and (2) between hepatitis C cohort and the general population.