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State of Care for Veterans with Chronic
The purpose of this report is to characterize the state of care of the population of Veterans with chronic hepatitis C (HCV) within the US Department of Veterans Affairs' (VA) Veterans Health Administration (VHA). The first step in providing responsive care is to learn about the affected population. This report describes the distribution of Veterans with chronic HCV within VHA and provides basic demographic data on this population. Additionally, the report describes pharmacologic treatment, other conditions commonly seen in Veterans with chronic HCV, and indicators of healthcare quality including screening, monitoring, and outcomes assessment. This report contains information that can be used to assess and guide interventions to improve the quality of care VHA delivers to Veterans with chronic HCV.
The report has a series of chapters, each covering a limited aspect of VHA care for Veterans with chronic HCV. Please refer to the Table of Contents for a quick reference to key sections within each chapter. The report contains summary information at the national, regional (Veterans Integrated Service Network, or VISN), and local healthcare system levels. To improve readability, large tables appear in the Appendix; smaller tables and figures appear within the text. References and general methods are described at the end of each chapter.
This is the first comprehensive summary report on Veterans with chronic HCV produced by the Public Health Strategic Healthcare Group (PHSHG). PHSHG was assigned responsibility for the National Hepatitis C Clinical Program in 2001. Since then, PHSHG has initiated numerous educational, training, and quality initiatives, the majority led by the National Hepatitis C Resource Centers, targeting various VHA providers responsible for hepatitis C care. In 2006, PHSHG, in conjunction with the Office of Information Technology, launched a new population management tool, the Clinical Case Registry (CCR), which greatly expanded access both locally and nationally to medical information for Veterans with chronic HCV. Data from the CCR serves as the foundation for this report. Where available, comparisons are made between Veterans with chronic HCV in care recently and during earlier periods.
With the goal of continual improvement in VHA care for Veterans with chronic HCV, PHSHG is committed to making these data available to front-line clinicians, VHA policy makers and researchers. This report would not be possible without the efforts of VHA staff located at VHA facilities across the county. PHSHG staff who are responsible for review of the quality of HCV care and who were instrumental in the development of this report are listed in the acknowledgements section. This report is dedicated to them and to the Veterans we serve.
Janet Durfee, RN, MSN, APRN
Acting Chief Consultant
Public Health Strategic Healthcare Group
Office of Public Health and Environmental Hazards