Association of insurance coverage with chlamydia screening.

Objectives: To examine the rates of self-reported Chlamydia trachomatis (CT) screening among young women and to examine the independent association of type of insurance and specific health plans with these rates.

Study Design: Cross-sectional analyses of the 2003 California Health Interview Survey data.

Methods: Using bivariate analysis and logistic regression models, we assessed the CT screening rate of 1659 sexually active women age 18-25 years, given various factors including type of health insurance coverage.

Chlamydia screening in a Health Plan before and after a national performance measure introduction.

Objective: To evaluate chlamydia-screening policies, testing practices, and the proportion testing positive in response to the new Health Plan Employer Data and Information Set (HEDIS) chlamydia-screening performance measure in a large commercial health plan.

Methods: We interviewed health plan specialty departmental chiefs to describe interventions used to increase chlamydia screening and examined electronic medical records of 15- to 26-year-old female patients--37,438 from 1998 to 1999 and 37,237 from 2000 to 2001--who were classified as sexually active by HEDIS specifications to estimate chlamydia testing and positive tests 2 years before and after the HEDIS measure introduction.

Results: In January 2000, the obstetrics and gynecology department instituted a policy to collect chlamydia tests at the time of routine Pap tests on all females 26 years old or younger by placing chlamydia swabs next to Pap test collection materials.

Validation of data collection for the HEDIS performance measure on chlamydia screening in an MCO.

Objective: To determine the validity of calculating the chlamydia Health Plan Employer Data and Information Set (HEDIS) measure using administrative data available in a mixed-model managed care organization (MCO).

Study Design: Retrospective cohort study.

Methods: A review of International Classification of Diseases, Ninth Revision (ICD-9), Current Procedural Termin-ology (CPT), Healthcare Common Procedure Coding System (HCPCS), and National Drug Code codes and electronic laboratory files in 1998 and a medical chart review to validate sexual activity and chlamydia testing codes specified by the National Committee for Quality Assurance (NCQA) in 1999 for the chlamydia HEDIS 2000 measure.

Optimal resource allocation for curing Chlamydia trachomatis infection among asymptomatic women at clinics operating on a fixed budget.

Goal: The goal was to determine the optimal strategy for screening coverage, test selection, and treatment for infection in asymptomatic women for a given family-planning-program budget.

Study Design: We developed a resource allocation model to determine the optimal strategy using data from 5078 visits by women universally screened for infection in a publicly funded family planning clinic system in Philadelphia. We maximized the number of infected women cured from the clinic perspective and maximized the cost-savings from the healthcare system perspective.

Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections--2002.

Since publication of CDC's 1993 guidelines (CDC, Recommendations for the prevention and management of Chlamydia trachomatis infections, 1993. MMWR 1993;42[No. RR-12]:1-39), nucleic acid amplification tests (NAATs) have been introduced as critical new tools to diagnose and treat C.

Understanding sexual activity defined in the HEDIS measure of screening young women for Chlamydia trachomatis.

Background: Periodic screening of sexually active young women for Chlamydia trachomatis is widely recommended and is now monitored in the Health Plan Employer Data and Information Set (HEDIS). Because little is known about how well the HEDIS measure identifies sexually active women eligible for screening, rates of sexual activity as defined by the measure's specifications were compared with those derived from self-reported sexual behavior and use of sexual health services among privately insured women.

Methods: Using the 1996 MarketScan claims data for privately insured women aged 15-25 years, a measure of sexual activity based on the HEDIS specifications for sexual activity was calculated, that is, claims for Pap tests and pelvic examinations, contraceptive services, pregnancy-related service, and screening and treatment for sexually transmitted diseases.