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Table 1.

Cascade of care definitions.

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Table 2.

Baseline characteristics of patients referred and completing an evaluation.

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Fig 1.

Cascade of care and reasons for lack of progression.

Of 187 patients meeting inclusion criteria, 120 (64%) completed an evaluation for HCV treatment, 119 (64%) were prescribed treatment, 114 (61%) were approved for treatment, 113 (60%) initiated treatment, 107 (57%) completed treatment, and 100 (53%) achieved a SVR. The largest lack of progression was seen from a referral to an evaluation with 51 patients never attending a scheduled clinic appointment. After an evaluation was completed, the most common reason for lack of progression was losing a patient to follow-up, defined as ≥5 attempts to contact the patient were made by phone as well as a letter sent to the patient’s most recent address with no response over at least three months.

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Table 3.

Characteristics associated with evaluation completion.

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Table 3 Expand

Fig 2.

Time-to-approval analysis.

Insurance type was a significant predictor of the rate in days to approval of direct acting antiviral therapy. The rate in days to approval decreased by 73% in patients with Medicaid compared with non-Medicaid (HR = 0.27, 95% CI = 0.15 to 0.48, p<0.001), reflecting a longer time to treatment approval in this population.

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