Evaluation of a pilot emergency department linkage to care program for patients previously diagnosed with Hepatitis C

Zak Hyde, Raúl Roura, Danielle Signer, Anuj Patel, Jacob Cohen, Mustapha Saheed, Sherilyn Brinkley, Risha Irvin, Mark S. Sulkowski, David L. Thomas, Richard E. Rothman, Yu Hsiang Hsieh

Research output: Contribution to journalArticlepeer-review


There is a significant number of Emergency Department (ED) patients with known chronic hepatitis C virus (HCV) infection who have not been treated with directly acting antivirals. We implemented a pilot ED-based linkage-to-care program to address this need and evaluated the impact of the program using the HCV Care Continuum metrics. Between March 2015 and May 2016, dedicated patient care navigators identified HCV RNA-positive patients in an urban ED and offered expedited appointments with the on-site viral hepatitis clinic. Patient demographics and care continuum outcomes were abstracted from the EMR and analysed to determine significant factors influencing linkage-to-care (LTC) and treatment initiation rates. The ED linkage-to-care program achieved a 43% linkage-to-care rate (165/384), 22% treatment rate (84/384) and 16% sustained virologic response rate (63/384). Significant associations were found between linkage-to-care and increasing age (OR = 1.03), Medicare insurance (OR = 2.21) and having a primary care physician (PCP) (OR = 4.03). For patients who were linked, the odds of initiating treatment were also positively significantly associated with increasing age (OR = 1.04) and having a PCP (OR = 2.77). For patients who initiated treatment, the odds of sustained virologic response were marginally associated with having a PCP (OR = 4.92).Our ED linkage-to-care program utilized care coordination to successfully link nearly half of approached HCV RNA-positive patients to care. This design can be feasibly replicated by other EDs given limited non-clinical training required for linkage-to-care staff. Adoption of similar programs in other EDs may improve the rates of LTC and treatment initiation for previously diagnosed HCV patients.

Original languageEnglish (US)
Pages (from-to)129-137
Number of pages9
JournalJournal of viral hepatitis
Issue number2
StatePublished - Feb 2023


  • Hepatitis C
  • continuity of patient care
  • emergency department
  • linkage to care
  • pilot project

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology
  • Hepatology


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