Author information
1
Facente Consulting, 5601 Van Fleet Avenue, Richmond, CA 94804, USA.
2
Community Health Equity and Promotion Branch, San Francisco Department of Public Health, 25 Van Ness Suite 500, San Francisco, CA 94102, USA.
3
San Francisco Department of Public Health, Medical Respite and Sobering Center, 101 Grove Street, Room 118, San Francisco, CA 94102, USA; Tom Waddell Integrated Medical Services, San Francisco Health Network, San Francisco Department of Public Health, 101 Grove Street, Room 118, San Francisco, CA 94102, USA; Department of Family and Community Medicine, University of California, San Francisco (UCSF), Zuckerberg, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
4
ARCHES Branch, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102, USA.
5
Clinical Practice, Southeast Health Center, San Francisco Health Network, San Francisco Department of Public Health, ZSFG Office at Ward 82 Room 246, 2401 Keith Street, San Francisco, CA 94124, USA; University of California, San Francisco (UCSF), Zuckerberg, San Francisco General Hospital, ZSFG Office at Ward 82 Room 246, 995 Potrero Ave San Francisco, CA 94110, USA. Electronic address: colleen.lynch@sfdph.org.
Abstract
In the pre-direct-acting antiviral era, hepatitis C virus (HCV) treatments were complex and largely managed by hepatologists, gastroenterologists, and infectious disease physicians. As direct-acting antivirals have driven up demand for treatment, the relative scarcity of these specialists has created a bottleneck effect, resulting in only a fraction of HCV-infected individuals offered treatment. The San Francisco Health Network is a safety net system of care. Its intervention was designed to be sustainable and scalable; with minimal time commitments for training providers, primary care-based HCV treatment increased 3-fold in a period of just over 3 years.