Health Services Research & Development

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Byrne T, Troszak L, Midboe AM, Fincke BG, Shwartz M, Gifford AL, McInnes DK. A Novel Measure to Assess Variation in Hepatitis C Prevalence Among Homeless and Unstably Housed Veterans, 2011-2016. Public health reports (Washington, D.C. : 1974). 2019 Mar 1; 134(2):126-131.
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Abstract: We constructed a novel measure of homelessness to examine differences in hepatitis C virus (HCV) prevalence across 3 categories of unstably housed and homeless veterans and across US Department of Veterans Affairs Medical Center facilities. We used Veterans Affairs administrative data to classify a cohort of 434?240 veterans as at risk of homelessness, currently homeless, or formerly homeless, and we examined variation in HCV prevalence by using descriptive measures and mixed-effect logistic regression models. HCV prevalence was highest among veterans who were formerly homeless (16.7%; 32?490 of 195?000), followed by currently homeless (12.4%; 22?050 of 178?056) and at risk of homelessness (8.2%; 5015 of 61?184). Veterans Affairs Medical Center-level prevalence ranged from 5.4% to 21.5%. Differences in HCV prevalence were significant by sex, race/ethnicity, and age. Targeting specific populations of homeless veterans for tailored HCV interventions and allocating additional resources to certain Veterans Affairs Medical Centers may be warranted.