Background:

Patient navigation interventions can improve health outcomes in underserved, low-income and racial and ethnic minority groups, who often experience health disparities. We examined the effectiveness of patient navigation to improve linkage to hepatitis C virus (HCV) treatment receipt in a socioeconomically disadvantaged, racially diverse patient population.

Methods:

We performed a pre-post analysis evaluating the effectiveness of a patient navigation program among baby boomers who tested positive for HCV in a safety-net health system. The usual care group (June 2013 – May 2015) and patient navigation group (January 2016 – December 2017) were balanced using a stabilized inverse probability of treatment weighting approach. We used logistic regression analyses to evaluate associations between patient navigation and linkage to care for HCV treatment evaluation, treatment initiation, and sustained virologic response (SVR).

Results:

Among 1353 patients (62% black, 61% uninsured, 16% homeless), 769 were in the usual care group and 584 in the patient navigation group. The patient navigation group had significantly higher odds of linkage to care (OR 3.7 95%CI 2.9-4.8) and treatment initiation (OR 3.2, 95%CI 2.3-4.2) within 6 months. The patient navigation group continued to have increased linkage to care (OR 3.4, 95%CI 2.7-4.3) and treatment initiation (OR 2.3, 95%CI 1.7-3.0) at 12 months. However, there was no significant difference in SVR between the groups (86.9% vs 86.1%, p=0.78).

Conclusion:

Patient navigation was associated with significantly increased linkage to care and treatment initiation among HCV-infected patients. Patient navigation programs can be used to promote HCV elimination among traditionally difficult-to-reach patient populations.