Background:
This study investigates the geographic distribution of client characteristics and service settings for Hepatitis C patients receiving treatment through the North Jersey Community Research Initiative’s Mobile Hepatitis C Elimination Clinic. The clinic operates in substance use facilities, harm reduction centers, and high-need areas to expand access to screening and treatment. The mobile clinic supports inpatient and outpatient treatment environments depending on the care delivery site.
Methods:
This study analyzed 817 patient records with a known outcome from 12/23/20, to 08/28/24, across New Jersey’s urban (14 zip codes, 38.9%), suburban (17 zip codes, 47.2%), and rural (5 zip codes, 13.9%) areas. Key variables included sex, age group, race/ethnicity, service setting (inpatient/outpatient), and sustained virologic response (SVR) achievement. Chi-square and Kruskal-Wallis tests assessed associations between geographic classification and demographic variables, including service settings.
Results:
Significant differences were observed in service setting (p < 0.0001), age group distribution (p = 0.0126), and race (p < 0.0001). Urban areas had the highest inpatient (66.7%), while outpatient dominated suburban (87.0%) and rural (97.3%) locations. Urban areas also had more older patients (48.1%) and greater racial diversity, while White patients were predominant in suburban (49.0%) and rural (65.3%) areas. SVR achievement rates (p = 0.707) and sex distribution (p = 0.273) were not statistically significant, though males were most prevalent (64.9% urban).
Conclusion:
Hepatitis C disproportionately affects underserved populations with limited healthcare access. This study highlights geographic disparities, showing that urban areas rely more on inpatient services, while suburban and rural areas primarily use outpatient care. Racial and age-related differences suggest the need for targeted outreach to improve equitable screening and treatment. The mobile clinic’s dual inpatient-outpatient model demonstrates mobile healthcare’s adaptability in reaching diverse populations. While SVR rates remain high, variations in service use suggest barriers to access and treatment adherence, underscoring the need for tailored interventions. |