{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T10:38:21Z","timestamp":1774607901813,"version":"3.50.1"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol. Commun."],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>We sought to identify specific gaps in preventive care provided to outpatients with cirrhosis and to determine factors associated with high quality of care (QOC), to guide quality improvement efforts. Outpatients with cirrhosis who received care at a large, academic tertiary health care system in the United States were included. Twelve quality indicators (QIs), including preventive care processes for ascites, esophageal varices, hepatic encephalopathy, hepatocellular carcinoma (HCC), and general cirrhosis care, were measured. QI pass rates were calculated as the proportion of patients eligible for a QI who received that QI during the study period. We performed logistic regression to determine predictors of high QOC (\u2265 75% of eligible QIs) and receipt of HCC surveillance. Of the 439 patients, the median age was 63\u00a0years, 59% were male, and 19% were Hispanic. The median Model for End\u2010Stage Liver Disease\u2013Sodium score was 11, 64% were compensated, and 32% had hepatitis C virus. QI pass rates varied by individual QIs, but were overall low. For example, 24% received appropriate HCC surveillance, 32% received an index endoscopy for varices screening, and 21% received secondary prophylaxis for spontaneous bacterial peritonitis. In multivariable analyses, Asian race (odds ratio [OR]: 3.7, 95% confidence interval [CI]: 1.3\u201010.2) was associated with higher QOC, and both Asian race (OR: 3.3, 95% CI: 1.2\u20109.0) and decompensated status (OR: 2.1, 95% CI: 1.1\u20104.2) were associated with receipt of HCC surveillance. A greater number of specialty care visits was not associated with higher QOC. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Receipt of outpatient preventive cirrhosis QIs was variable and overall low in a diverse cohort of patients with cirrhosis. Variation in care by race\/ethnicity and illness trajectory should prompt further inquiry into identifying modifiable factors to standardize care delivery and to improve QOC.<\/jats:p>","DOI":"10.1002\/hep4.1594","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T14:32:57Z","timestamp":1601044377000},"page":"1802-1811","source":"Crossref","is-referenced-by-count":8,"title":["Identifying Quality Gaps in Preventive Care for Outpatients With Cirrhosis Within a Large, Academic Health Care System"],"prefix":"10.1097","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0068-0099","authenticated-orcid":false,"given":"Ani","family":"Kardashian","sequence":"first","affiliation":[{"name":"Vatche and Tamar Manoukian Division of Digestive Diseases,Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"},{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-4531","authenticated-orcid":false,"given":"Arpan A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Vatche and Tamar Manoukian Division of Digestive Diseases,Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"},{"name":"Veterans Affairs Greater Los Angeles Healthcare System,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth S.","family":"Aby","sequence":"additional","affiliation":[{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivy T.","family":"Cusumano","sequence":"additional","affiliation":[{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille","family":"Soroudi","sequence":"additional","affiliation":[{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam C.","family":"Winters","sequence":"additional","affiliation":[{"name":"Vatche and Tamar Manoukian Division of Digestive Diseases,Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"},{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1009-6248","authenticated-orcid":false,"given":"Eric","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Beah","sequence":"additional","affiliation":[{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Delshad","sequence":"additional","affiliation":[{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liu","family":"Yang","sequence":"additional","affiliation":[{"name":"Vatche and Tamar Manoukian Division of Digestive Diseases,Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Folasade P.","family":"May","sequence":"additional","affiliation":[{"name":"Vatche and Tamar Manoukian Division of Digestive Diseases,Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"},{"name":"Department of Medicine,David Geffen School of Medicine at UCLA,Los Angeles,CA"},{"name":"Veterans Affairs Greater Los Angeles Healthcare System,Los Angeles,CA"},{"name":"Jonsson Comprehensive Cancer Center,UCLA,Los Angeles,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"hep41594-bib-0001-20240114","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1097\/MCG.0000000000000208","article-title":"The epidemiology of cirrhosis in the United States: a population\u2010based study","volume":"49","year":"2015","journal-title":"J Clin Gastroenterol"},{"key":"hep41594-bib-0002-20240114","first-page":"k2817","article-title":"Mortality due to cirrhosis and liver cancer in the United States, 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