筛查乙型肝炎病毒是预防乙型肝炎肝硬化和肝细胞癌的首要决策点，最终有助于消除一种可治愈的疾病。本研究旨在描绘2020年在美国大型医疗系统中实施电子健康记录（EHR）警报普及筛查后，HCV筛查率和筛查人口特征随时间的变化。从2017年1月1日至2021年10月31日，从EHR中提取了所有门诊患者的数据，包括个体人口统计学和其HCV抗体（Ab）筛查日期。在HCV警报实施期间为限，执行混合效应多变量回归分析，比较已筛查和未筛查患者的时间线和特征。最终的模型包括感兴趣的社会人口统计学协变量、时间段（前/后）以及时间段和性别之间的交互项。我们还检查了一个具有月度时间变量的模型，以了解COVID-19对HCV筛查的潜在影响。采用普及性EHR警报后，筛查人数和筛查率分别增加了103%和62%。具有Medicaid保险的患者比私人保险更有可能接受筛查（ORadj 1.10，95% CI：1.05，1.15），而具有Medicare保险的患者则不太可能接受筛查（ORadj 0.62，95% CI：0.62，0.65），黑种人（ORadj 1.59，95% CI：1.53，1.64）比白种人更可能接受筛查。普遍实施EHR警报可能成为消除HCV的关键下一步。具有Medicare和Medicaid保险的人未按这些人群的国家患病率比例接受筛查。我们的研究结果支持加强具有高HCV风险的人的筛查和重新测试工作。版权所有：© 2023 Hack等人。本文是一篇开放获取文章，在保持原作者和出处的情况下，无限制使用、分发和再制。

Screening for hepatitis C virus is the first critical decision point for preventing morbidity and mortality from HCV cirrhosis and hepatocellular carcinoma and will ultimately contribute to global elimination of a curable disease. This study aims to portray the changes over time in HCV screening rates and the screened population characteristics following the 2020 implementation of an electronic health record (EHR) alert for universal screening in the outpatient setting in a large healthcare system in the US mid-Atlantic region.Data was abstracted from the EHR on all outpatients from 1/1/2017 through 10/31/2021, including individual demographics and their HCV antibody (Ab) screening dates. For a limited period centered on the implementation of the HCV alert, mixed effects multivariable regression analyses were performed to compare the timeline and characteristics of those screened and un-screened. The final models included socio-demographic covariates of interest, time period (pre/post) and an interaction term between time period and sex. We also examined a model with time as a monthly variable to look at the potential impact of COVID-19 on screening for HCV.Absolute number of screens and screening rate increased by 103% and 62%, respectively, after adopting the universal EHR alert. Patients with Medicaid were more likely to be screened than private insurance (ORadj 1.10, 95% CI: 1.05, 1.15), while those with Medicare were less likely (ORadj 0.62, 95% CI: 0.62, 0.65); and Black (ORadj 1.59, 95% CI: 1.53, 1.64) race more than White.Implementation of universal EHR alerts could prove to be a critical next step in HCV elimination. Those with Medicare and Medicaid insurance were not screened proportionately to the national prevalence of HCV in these populations. Our findings support increased screening and re-testing efforts for those at high risk of HCV.Copyright: © 2023 Hack et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.