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Using a population-based approach to prevent hepatocellular cancer in New South Wales, Australia: effects on health services utilisation


, : Using a population-based approach to prevent hepatocellular cancer in New South Wales, Australia: effects on health services utilisation. Bmc Health Services Research 10(): 215-215

Australians born in countries where hepatitis B infection is endemic are 6-12 times more likely to develop hepatocellular cancer (HCC) than Australian-born individuals. However, a program of screening, surveillance and treatment of chronic hepatitis B (CHB) in high risk populations could significantly reduce disease progression and death related to end-stage liver disease and HCC. Consequently we are implementing the B Positive pilot project, aiming to optimise the management of CHB in at-risk populations in south-west Sydney. Program participants receive routine care, enhanced disease surveillance or specialist referral, according to their stage of CHB infection, level of viral load and extent of liver injury. In this paper we examine the program's potential impact on health services utilisation in the study area. Estimated numbers of CHB infections were derived from Australian Bureau of Statistics data and applying estimates of HBV prevalence rates from migrants' countries of birth. These figures were entered into a Markov model of disease progression, constructing a hypothetical cohort of Asian-born adults with CHB infection. We calculated the number of participants in different CHB disease states and estimated the numbers of GP and specialist consultations and liver ultrasound examinations the cohort would require annually over the life of the program. Assuming a 25% participation rate among the 5,800 local residents estimated to have chronic hepatitis B infection, approximately 750 people would require routine follow up, 260 enhanced disease surveillance and 210 specialist care during the first year after recruitment is completed. This translates into 5 additional appointments per year for each local GP, 25 for each specialist and 420 additional liver ultrasound examinations. While the program will not greatly affect the volume of local GP consultations, it will lead to a significant increase in demand for specialist services. New models of CHB care may be required to aid program implementation and up scaling the program will need to factor in additional demands on health care utilisation in areas of high hepatitis B sero-prevalence.

US$19.90

PMID: 20663140

DOI: 10.1186/1472-6963-10-215


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Luo, L.; Yuan, X.; Huang, W.; Ren, F.; Zhu, H.; Zheng, Y.; Tang, L., 2016: Safety of coadministration of ezetimibe and statins in patients with hypercholesterolaemia: a meta-analysis. Hypercholesterolaemia is a pivotal risk factor for cardiovascular and cerebrovascular disease and is treated with many effective lipid-lowering agents. Statins are often used alone or in combination with ezetimibe. Combination therapy is more effe...

Martin, G.M.; Sprague, C.A., 1969: Parasexual cycle in cultivated human somatic cells. Somatic segregation for three different autosomes was demonstrated in two strains of human diploid fibroblasts derived from subjects known to be heterozygous for chromosomal variants. Recombinant diploid cells appeared within cultures of tetraploi...

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Mo, H.H.; Yang, K.W.; An, F.C.; Zhang, L.Z.; Xu, X.B.; Yang, D.W.; Yang, S.X.; Lei, Z.D., 1991: Movement of pesticides in soil. Pollution due to leaching of the pesticide 1-(2-chlorobenzyl) -3-(4-chlorophenyl) urea (CCU) is predicted using a transport and transfer model of pesticide in unsaturated soil. The relation between leaching of pesticide in soil and its physical an...

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Bao Chun He, C.Z.M.ng; D.Y.M.n, 1996: Improved synthesis of nimodipine. Zhongguo Yiyao Gongye Zazhi 27(7): 295-296

Shebl, O.; Ebner, T.; Sommergruber, M.; Sir, A.; Urdl, W.; Tews, G., 2007: Multiple pregnancies after ART: problems and possible solutions. Multiple pregnancies following an assisted reproduction technique (ART) should be seen as a complication, and for that reason they should be avoided. In contrast to singleton pregnancies following ART, the multiple pregnancies are associated with...

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