However it is necessary to raise the rate of notification and referral further

However it is necessary to raise the rate of notification and referral further. chemiluminescent immunoassays were investigated for whether they were notified of the positive results and if they were referred to gastroenterologists at our hospital. The notification and referral rate was compared before (from January to December 2014) and after the introduction of the alert system (from February to September 2016). Results HBsAg-positive rate was 1.1% (69/6543) before the introduction of the alert system and 0.8% (41/5403) after it. The notification rate has significantly improved from 46% to 73% (values 0.05 were considered to be statistically significant. The difference of rates was also assessed by 95% confidential interval. Results Preliminary investigation HBsAg was measured in 6543 patients, of whom 69 (1.1%) were positive. Anti-HCV antibody was measured in 6481 patients, of whom 139 (2.1%) were positive. The major departments where the hepatitis assessments were undergone were emergency department, orthopedics department, and urology department. The positive rate for anti-HCV antibody was the highest in nephrology department (4.20% [6/143]) (Table ?(Table11). Table 1 Distribution of patients tested for HBsAg or anti-HCV antibody at departments other than the gastroenterology department thead th rowspan=”2″ colspan=”1″ Department /th th colspan=”3″ rowspan=”1″ HBsAg /th th colspan=”3″ rowspan=”1″ anti-HCV antibody /th th rowspan=”1″ colspan=”1″ Quantity of patients tested /th th rowspan=”1″ colspan=”1″ Quantity of positive patients /th th rowspan=”1″ colspan=”1″ Positive rate (%) /th th rowspan=”1″ colspan=”1″ Quantity of patients tested /th th rowspan=”1″ colspan=”1″ Quantity of positive patients /th th rowspan=”1″ colspan=”1″ Positive rate (%) /th /thead emergency1318161.211391402.88orthopedics surgery893131.46873212.41urology759121.58754192.52gastrointestinal surgery56430.53610152.46obstetrics and gynecology50430.6050410.20cardiology39210.26369102.71respiratory medicine34561.74336123.57otorhinolaryngology30110.3327910.36cranial nerve surgery29310.3427910.36plastic and reconstructive surgery24220.8325131.20ophthalmology1850019742.03dermatology17821.1212321.63nephrology15010.6714364.20rheumatology7311.376100hematology6411.565111.96dental surgery6311.596300general medicine5723.515024.00neurology4912.044812.08pediatrics3412.942100diabetes medicine and endocrinology34003100cardiovascular surgery2913.452900medical oncology600800geriatrics500400anesthesiology400500psychiatry100100Total6543691.0564811392.14 Open in a separate window Of the patients positive for HBsAg and anti-HCV antibody, 42 (61%) and 86 (62%) were male, respectively. HBsAg-positive rates were 0.4% (1/224) in teens, 0.3% (1/361) in 20s, 0.7% (4/596) in 30s, 0.9% (5/569) in 40s, 2.2% (15/693) in 50s, 1.5% (19/1267) in 60s, 0.9% (14/1619) in 70s, and 1.2% (10/849) in SB-224289 hydrochloride 80s. Anti-HCV antibody-positive rates were 0.5% (3/585) in 30s, 1.3% (7/551) in 40s, 1.5% (10/687) in 50s, 2.5% (32/1267) in 60s, 2.8% (45/1615) in 70s, 4.5% (38/850) in 80s, and 2.9% (4/140) in 90s. A total of 46% (32/69) of the HBsAg-positive patients and 35% (48/139) of the anti-HCV antibody-positive patients were notified of the results (Fig. 1a and b). There were 16% (11/69) of the HBsAg-positive patients and 6% (8/139) of the anti-HCV antibody-positive patients who were referred to gastroenterologists (Fig. 2a and b). Open in a separate windows Fig. 1 The rate of HBsAg or anti-HCV antibody-positive patients who were notified of the results before and after the introduction of the alert system. a The rate of HBsAg-positive patients who were notified of the positive results increased significantly after the introduction of the alert system (95% confidential interval of difference of rate?=?8%?~?46%; em p /em ?=?0.0061). SB-224289 hydrochloride b The rate of anti-HCV antibody-positive patients who were notified of the results increased significantly after the introduction of the alert system (95% confidential interval of difference of rate?=?15%?~?39%; em p /em ? ?0.0001) Open in a separate window Fig. 2 The rate of HBsAg or anti-HCV antibody-positive patients who were referred to a gastroenterologist before and after the introduction of the alert system. a The rate of HBsAg-positive patients who were referred to Rabbit polyclonal to Caspase 6 gastroenterologists increased after the introduction of the alert SB-224289 hydrochloride system, while there was no statistical significance (95% confidential interval of difference of rate?=??5%?~?26%). b The rate of anti-HCV antibody-positive patients who were referred to a gastroenterologist increased significantly after the introduction of the alert system (95% confidential interval of difference of rate?=?9%?~?26%; em p /em ? ?0.0001) HBsAg-positive patients after the introduction of the alert system HBsAg was measured in 5403 patients, of whom 41 (0.7%) were positive. Of the HBsAg-positive patients, 73% (30/41) were notified of the results, which was a significantly higher rate than that before the introduction of the alert system (46% [32/69]; 95% confidential interval of difference of rate?=?8%?~?46%; em p /em ?=?0.0061) (Fig. ?(Fig.1a).1a). There were 27% (11/41) of the HBsAg-positive patients who were referred to gastroenterologists, a higher rate than that before the introduction of the alert system (16% [11/69]), while there was no statistical significance (95% confidential interval of difference of rate?=??5%?~?26%) (Fig. ?(Fig.2a2a). A total of 11 patients consulted gastroenterologists. Of these, seven patients initiated nucleoside/nucleotide analogues (NAs) therapy because of their chemotherapy or immunosuppressive therapy, three patients were diagnosed as asymptomatic service providers, and one patient declared no wish to receive an examination or treatment. There were 19 patients who were notified of the positive results but were not referred to a gastroenterologist. Of these, three patients were not with proper care (Table ?(Table22). Table 2 State of medical care of 19 patients who were notified of HBsAg-positive results but were not referred to the gastroenterologists thead th rowspan=”1″ colspan=”1″ State of medical care /th th colspan=”2″ rowspan=”1″ Quantity of patients /th /thead With proper care16?Undergoing nucleoside/nucleotide analogues therapy12?Seeing gastroenterologists at our hospital2?Attending other general hospitals2Without proper care3?Seeing.