Value-based care models for chronic hepatitis B and C among vulnerable populations: a scoping review

BACKGROUND: Chronic viral hepatitis B and C are a significant public health burden worldwide. The prevalence of these infections is much higher among migrants than in the general population, due to factors such as inadequate access to healthcare. The EU VH-COMSAVAC project aims to implement community-based HBV/HCV models of care among migrant populations with documented high HBV/HCV incidence and prevalence, using person-centred referral processes. Our study aims to provide an overview of the scientific evidence on value-based models of care for prevention, treatment and linkage-to-care in high-risk groups. METHODS: This scoping review was performed in the context of the EU VH-COMSAVAC project, following the PRISMA-ScR Checklist, by searching on 5 databases: Medline, EMBASE, GlobalHealth, Scopus and Web of Science. Articles published up to December 2020 investigating models of care targeting migrant populations and related to HBV/HCV prevention, treatment and linkage-to-care, were included. RESULTS: Out of a total of 2,767 articles screened, 83 were included and preliminarly categorized according to stages of care (prevention, treatment and linkage-to-care) and Bodenheimer’ pillars. Further investigation will be conducted concerning the dimensions of patient experience; utilized resources; population health; care-team well-being. CONCLUSIONS: Implementing patient-centered care models for critical public health issues among specific populations is becoming incresingly relevant. This study will provide the conceptual basis for building a value-based assessment tool capable of evaluating new models of care for prevention, treatment and linkage-to-care for hepatitis B/ C in high-risk groups. KEY MESSAGES: • In order to reach viral hepatitis elimination targets, initiatives must pay particular attention to high-risk groups. • The value (population health, patient experience, care-team wellbeing and costs) of such care strategies should be assessed to contribute to their continuity.