Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection
Background The syndemic between opioid use disorder (OUD), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) results in excessive burdens on the healthcare system. Integrating these siloed systems of care is critical to address all three conditions adequately. In this implementation pr...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2022.2084154 |
| _version_ | 1811216362465394688 |
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| author | Anthony J. Eller Elizabeth E. DiDomizio Lynn M. Madden Jennifer D. Oliva Frederick L. Altice Kimberly A. Johnson |
| author_facet | Anthony J. Eller Elizabeth E. DiDomizio Lynn M. Madden Jennifer D. Oliva Frederick L. Altice Kimberly A. Johnson |
| author_sort | Anthony J. Eller |
| collection | DOAJ |
| description | Background The syndemic between opioid use disorder (OUD), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) results in excessive burdens on the healthcare system. Integrating these siloed systems of care is critical to address all three conditions adequately. In this implementation project, we assessed the data capacity of the health system to measure a cascade of care (COC) across HIV, HCV and OUD services in five states to help guide public health planning.Materials and methods Data for this study were gathered from publicly available datasets and reports from government (SAMSHA, CMS, HRSA and CDC) sites. We created, where possible, COCs for HIV, HCV, and OUD spanning population estimate, diagnosis, treatment initiation, treatment retention, and patient outcomes for each of five states in the study.Results The process of data collection showed that baseline COCs examining the intersections of OUD, HIV, and HCV cannot be produced and that there are missing data in all states examined. Collection of specific data points is not consistent across all states. States are better at reporting HIV cascades due to federal requirements. Only gross estimates could be made for OUD cascades in all states because data are separated by payer source, leaving no central point of data collection from all sources. Data for HCV were not publicly available.Conclusion It is difficult to assess the strategies needed or the progress made towards increasing treatment access and decreasing the burden of disease without the ability to construct an accurate baseline. Using integrated COCs with relevant benchmarks can not only guide public health planning, but also provide meaningful targets for intervention.KEY MESSAGESWhile HIV COCs are available for most states at least annually, they are not disaggregated for populations with co-occurring OUD or HCV.Data to calculate HCV COC are not available and data to calculate OUD COC are partially available, but only for specific payers.States do not have systems in place to measure the scope of the syndemic or to identify targets for quality improvement activities. |
| first_indexed | 2024-04-12T06:37:48Z |
| format | Article |
| id | doaj.art-3787dfc0fd594bb1af17a8cd3b2e112d |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-04-12T06:37:48Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-3787dfc0fd594bb1af17a8cd3b2e112d2022-12-22T03:43:48ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602022-12-015411714172410.1080/07853890.2022.2084154Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collectionAnthony J. Eller0Elizabeth E. DiDomizio1Lynn M. Madden2Jennifer D. Oliva3Frederick L. Altice4Kimberly A. Johnson5Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USASection of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USASection of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Mental Health Law & Policy, University of South Florida, Tampa, FL, USASection of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USACenter for Health & Pharmaceutical Law, Seton Hall University School of Law, Newark, NJ, USABackground The syndemic between opioid use disorder (OUD), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) results in excessive burdens on the healthcare system. Integrating these siloed systems of care is critical to address all three conditions adequately. In this implementation project, we assessed the data capacity of the health system to measure a cascade of care (COC) across HIV, HCV and OUD services in five states to help guide public health planning.Materials and methods Data for this study were gathered from publicly available datasets and reports from government (SAMSHA, CMS, HRSA and CDC) sites. We created, where possible, COCs for HIV, HCV, and OUD spanning population estimate, diagnosis, treatment initiation, treatment retention, and patient outcomes for each of five states in the study.Results The process of data collection showed that baseline COCs examining the intersections of OUD, HIV, and HCV cannot be produced and that there are missing data in all states examined. Collection of specific data points is not consistent across all states. States are better at reporting HIV cascades due to federal requirements. Only gross estimates could be made for OUD cascades in all states because data are separated by payer source, leaving no central point of data collection from all sources. Data for HCV were not publicly available.Conclusion It is difficult to assess the strategies needed or the progress made towards increasing treatment access and decreasing the burden of disease without the ability to construct an accurate baseline. Using integrated COCs with relevant benchmarks can not only guide public health planning, but also provide meaningful targets for intervention.KEY MESSAGESWhile HIV COCs are available for most states at least annually, they are not disaggregated for populations with co-occurring OUD or HCV.Data to calculate HCV COC are not available and data to calculate OUD COC are partially available, but only for specific payers.States do not have systems in place to measure the scope of the syndemic or to identify targets for quality improvement activities.https://www.tandfonline.com/doi/10.1080/07853890.2022.2084154Opioid use disorderHCVHIVcascade of carecontinuum of careimplementation |
| spellingShingle | Anthony J. Eller Elizabeth E. DiDomizio Lynn M. Madden Jennifer D. Oliva Frederick L. Altice Kimberly A. Johnson Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection Annals of Medicine Opioid use disorder HCV HIV cascade of care continuum of care implementation |
| title | Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection |
| title_full | Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection |
| title_fullStr | Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection |
| title_full_unstemmed | Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection |
| title_short | Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection |
| title_sort | strengthening systems of care for people with or at risk for hiv hcv and opioid use disorder a call for enhanced data collection |
| topic | Opioid use disorder HCV HIV cascade of care continuum of care implementation |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2022.2084154 |
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