# The effectiveness of intervention in hepatitis C patients and improvement in their referral rate

## TL;DR

This study shows that using critical value alerts and SMS improved the referral rate for hepatitis C patients.

## Contribution

The study demonstrates a novel use of SMS and critical value management to improve patient referrals for hepatitis C.

## Key findings

- The referral rate significantly increased after implementing the intervention.
- Statistical tests confirmed a strong correlation between the intervention and improved referrals.
- The linear regression model showed the intervention had a significant positive effect.

## Abstract

To investigate the effectiveness of the intervention with critical value management and push short messaging service (SMS), and to determine improvement in the referral rate of patients with positive hepatitis C antibody (anti-HCV).

No intervention was done for patients with positive anti-HCV screening results from 1 January 2015 to 31 October 2021. Patients with positive anti-HCV results at our hospital from 1 November 2021 to 31 July 2022 were informed vide critical value management and push SMS. For inpatients, a competent physician was requested to liaise with the infectious disease physician for consultation, and patients seen in the OPD (outpatient department) were asked to visit the liver disease clinic. The Chi-square correlation test, one-sided two-ratio test and linear regression were used to test the relationship between intervention and referral rate.

A total of 638,308 cases were tested for anti-hepatitis C virus (HCV) in our hospital and 5983 of them were positive. 51.8% of the referred patients were aged 18–59 years and 10.8% were aged ≥75 years. The result of Chi-square correlation test between intervention and referral was p = .0000, p < .05. One-sided two-ratio test was performed for statistics of pre-intervention referral rate (p1) and post-intervention referral rate (p2). Normal approximation and Fisher’s exact test for the results obtained were 0.000, p < .05, and the alternative hypothesis p1 − p2 < 0 was accepted. The linear regression equation was referral = 0.1396 × intervention + 0.3743, and the result model p = 8.79e − 09, p < .05. The model was significant, and the coefficient of intervention was 0.1396.

The interventions of critical value management and push SMS were correlated with the referral rate of patients with positive anti-HCV.