Barriers associated with screening and access to care of patients with viral Hepatitis C
in Constanta, Romania – Th e Experience Of Baylor Black Sea Foundation
Issues
Description
Lessons learned
Next steps
Authors:
Mihaela Bogdan, Florentina Popa, Septar
Negivan, Cristiana Barcer, Margareta Eftimie, Roxana
Popescu, Corina Pop, Rodica Mihai – Baylor Black Sea
Foundation- BIPAI Romania
Chronic hepatitis C represents a national health problem in Romania with an incidence of 3 -7.5 %. By compari-
son the cumulative number of people who have ever been treated in Romania is around 30 000. However there
are a number of factors that prevent or hinder the access to antiviral treatment for patients confi rmed with hepa-
titis C that we were able to identify and understand through our HIV and hepatitis Band C screening program.
Baylor Romania has tested for VHC 12 596 persons; 395 people tested positive for Hepatitis C, 155 of the eligi-
ble cases were confi rmed and assisted to submit their medical fi les for approval in order to access the antiviral
treatment for hepatitis C.
Th e obstacles that a patient encounters within the health system are linked to the following key phases:
(1) referral for testing,
(2) diagnosis confi rmation and
(3) preparation and submission of the medical fi les to Health Insurance,
(4) access to the antiviral treatment and
(5) patient follow up and support during treatment.
Th ere are barriers related to the system and barriers related to the patients. Each type of obstacle and its impli-
cations will be identifi ed and presented.
One of the most common barriers related to patients is misinformation about the treatment. Access to cor-
rect information, empowering patients to advocate for their rights and practical support to access treatment
are strategies to fi ll this gap. We have learned that it is vital to have local partners in order to facilitate patients’
journey through the twists and turns of the medical system. An important role during the treatment is psycho-
social monitoring of patients. Baylor is pioneering this type of support in for romanian patients with hepatitis
C .
Th e model of multidisciplinary care
developed by the Baylor Centre
of Excellence for HIV infected pa-
tients has many care components
that can be replicated for the ben-
efi t of patients and families aff ected
by hepatitis. Building on the HIV
experience, we aim to fi nd innova-
tive solutions to address the most
common barriers that patients with
hepatitis C encounter while seek-
ing care.