Promoting notification and linkage of HBs antigen and anti-HCV antibody-positive patients through hospital alert system

Naoki Yoshioka, Akihiko Okumura, Yukie Yamamoto, Katsura Yamaguchi, Atsuro Kaga, Kentaro Yamada, Takuya Hirosaki, Daisuke Ishikawa, Shin Kunii, Kazumasa Watanabe, Setsuo Utsunomiya, Kazuhiko Hayashi, Masatoshi Ishigami, Hidemi Goto, Yoshiki Hirooka

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Abstract

Background: In Japan, approximately 0.9% and 1% of the whole population are infected with HBV and HCV, respectively. Doctors from departments other than gastroenterology often order viral hepatitis tests before an invasive examination or an operation. However, the notification of positive results to the patients and linkage to care is not appropriately performed. The in-hospital alert system was constructed to promote the notification and referral to gastroenterologists for patients with positive viral hepatitis tests, and its efficacy was evaluated. Methods: The patients who tested HBsAg and anti-HCV antibody by chemiluminescent enzyme immunoassays and chemiluminescent immunoassays were investigated for whether they were notified of the positive results and if they were referred to gastroenterologists at our hospital. The notification and referral rate was compared before (from January to December 2014) and after the introduction of the alert system (from February to September 2016). Results: HBsAg-positive rate was 1.1% (69/6543) before the introduction of the alert system and 0.8% (41/5403) after it. The notification rate has significantly improved from 46% to 73% (p=0.0061) and the referral rate has improved from 16% to 27%, while not significant. Positive rate of anti-HCV antibody was 2.1% (139/6481) before the introduction of the alert system and 2.4% (128/5322) after it. The rate of notification and referral has significantly improved from 35% to 62% (p<0.0001) and from 6% to 23% (p<0.0001), respectively. Conclusions: The in-hospital alert system increased the rates of notification and referral of the patients with positive viral hepatitis tests. Enlightenment of doctors other than gastroenterologists on viral hepatitis and cooperation of medical staffs would be helpful to improve the notification and referral rates.

Original languageEnglish
Article number330
JournalBMC Infectious Diseases
Volume17
Issue number1
DOIs
Publication statusPublished - 08-05-2017

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

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    Yoshioka, N., Okumura, A., Yamamoto, Y., Yamaguchi, K., Kaga, A., Yamada, K., Hirosaki, T., Ishikawa, D., Kunii, S., Watanabe, K., Utsunomiya, S., Hayashi, K., Ishigami, M., Goto, H., & Hirooka, Y. (2017). Promoting notification and linkage of HBs antigen and anti-HCV antibody-positive patients through hospital alert system. BMC Infectious Diseases, 17(1), [330]. https://doi.org/10.1186/s12879-017-2438-1