Skip Maine state header navigation
Executive Summary
A Comprehensive Statewide
Needs Assessment February 2001 |
Published by the Maine Center for Public Health for the Maine Hepatitis C Infection Needs Assessment Steering Committee |
Introduction Hepatitis
C is a growing--and costly--public health threat to the people of Maine.
Hepatitis C virus, an easily transmitted, bloodborne infectious organism, results in chronic infection of the liver in 85% of those exposed. This one infection contributes to 40% of chronic liver disease in the country. It is the leading indication for liver transplantation in American adults. An
estimated 15,000 Maine residents have chronic hepatitis C infection.
Yet, because of the slow progression of the disease and its lack of
outward symptoms early on, most are totally unaware of their infection.
Since most infected persons have not been tested, their
opportunities for preventive and therapeutic care are being lost. Of the
estimated 15,000 Mainers now infected with the hepatitis C virus, fewer
than 2,000 have been tested or have received medical care for their
infection. Even
so, with just about one-in-ten Mainers with hepatitis C infection
identified and in treatment, the epidemic is estimated to have cost
Medicaid over $12 million last year--a six-fold increase in four years.
And this is just the beginning. Maine has arrived at a crucial juncture--a crossroads--in the hepatitis C epidemic in our state. This report seeks to give a full description of where we are and the choices before us as a state. What
has Maine been doing to address hepatitis C infection?
In
1997, the Maine Bureau of Health (BOH) initiated mandatory case
reporting of chronic hepatitis C infection.
In December of that same year, the BOH convened the first
quarterly meeting of the Maine Hepatitis C Working Group. This group
included clinicians, patient advocates, and public health professionals
interested in sharing information.
Most of its efforts focused on educating primary care physicians
about hepatitis C infection. After
developing a plan for the needs assessment, financial resources were
obtained from the Maine Bureau of Health’s Division of Disease
Control, as well as from Schering Other
components of the assessment included: a review of Maine hepatitis C
epidemiologic surveillance data and hepatitis C infection health care
expenditure data; a review of the medical and public health literature;
and phone interviews with public health officials from other states.
Additional data were collected through two surveys: one, a sample
of primary care health providers and gastroenterologists in Maine
(conducted in collaboration with Portland Public Health), and the other
a national survey of prison medical directors (conducted in
collaboration with the Department of Corrections). On
November 9, 2000 the results of the needs assessment were presented to
the Steering Committee and these findings were reviewed and discussed.
Through a consensus-building process, the Committee determined
six recommendations for addressing hepatitis C in Maine. These recommendations are presented in the final section of
this report. 1 While these corporations partially funded the needs assessment, they
did not guide, review, or in any other way participate in the
needs assessment.
|