Differences among hepatitis C patients seen in community and specialist outpatient care settings

Background: In the province of New Brunswick, care for patients infected with hepatitis C is provided in both community-based care settings and specialist-based care settings, but little is known about the differences between these populations. The aim of the current study is to characterize the demographic, socioeconomic, mental health and substance use factors of patients seen in these settings. Methods: Enrolling sites for this study included four specialist office-based clinics and one community-based clinic in three communities in New Brunswick. Personal health data was collected with informed consent via questionnaires and medical records. Non-incarcerated patients seen between April 2014 and April 2016 were included in the analysis. Results: A total of 374 patients were included (34.8% community versus 65.2% specialist office). Patients seen in the community care setting were younger (median age 43.7 versus 49.1 years), less likely to have a primary care provider (p = .007), rely on social assistance as regular source of income (p <.001), have been incarcerated (p = .007), reported sharing drug paraphernalia (p = .025), had recent injection drug use (p <.001), reported snorting drugs recently (p <.001) and reported prior overdose (p = .025). Community clinic patients also had significantly younger mean age at first use of alcohol (13.6 versus 14.7 years, p = .044), marijuana (14.6 versus 15.8, p = .040), and opioids (23.9 versus 26.5 years, p = .036) over those seen in specialist offices. Conclusions: Unique differences exist between patients seen in community and specialist care settings in New Brunswick. Understanding these differences is an essential first step in developing patient-centred care models.