Screening females for chlamydia trachomatis (CT) In a large managed care organization (Mco). A new hedis measure
Background: Since CT testing for females is a new Health Plan Employer Data and Information Set (HEDIS) measure to assess MCO quality of care, we determined the proportion of females enrolled in a large closed panel vertically integrated MCO serving a demographically diverse population who were tested for CT at least once during 1998 and resulting CT prevalences.Methods: A data base with MCO members >/= 12 yrs old tested with CT DNA probes (GenProbe) from 1/1/98-12/30/98 was examined. Only females 12-24 yrs old and enrolled at least 11 continuous months in 1998 were included in the analysis.Results: In 1998, 5425 (13.1%) of 41,566 females 12-24 yrs were CT tested and 849 (2.0%) tested positive at least once. Proportion of females tested and proportion of females testing positive at least once varied by age and clinic location. Among 11, 562 12-14 yr females, 277 (2.4%) were CT tested and 48 (0.4%) tested positive; among 18,155 15-19 yr females, 2,424 (13.4%) were tested and 572 (3.2%) tested positive; and among 11,849 20-24 yr females, 2, 724 (23.0%) were tested and 229 (1.9%) tested positive. The proportion 12-24 yr females tested was 579/3,945 (14.7%) with 92/3, 945 (2.3%) testing positive in the Baltimore area; in Washington, DC/Maryland area 2,999/21,085 (14.2%) were tested with 601/21,085 (2. 9%) testing positive; in Northern Virginia 1,847/16,536 (11.2%) were tested with 156/16,536 (0.9%) testing positive.Proportion of females with at least one positive test among those females who were tested for CT also varied by age and clinic location. Among 277 of 12-14 yr females tested 48 (17.3%) tested positive at least once; among 2,424 of 15-19 yr females tested, 572 (23.6%) tested positive at least once; and among 2,724 of 20-24 yr females tested, 229 (8.4%) tested positive at least once. The proportion of females tested with at least one positive test among 12-24 yr females was 92/579 (15.9%) in the Baltimore area, 601/2,999 (20.0%) in Washington DC/Maryland area, and 156/1,847 (8.4%) in Northern Virginia.Conclusion: CT testing of adolescent females 12-19 yrs revealed a high proportion of positive tests. The lower proportion of positive tests in young adults 20-24 yrs may be due to differences in prevalence and increased number of tests performed. CT testing practices and rates varied by location. Therefore, in a large MCO, a uniform system wide approach in identifying and screening sexually active adolescent females may identify a large reservoir or asymptomatic infection.
Burstein
G
Johns Hopkins University, Baltimore, MD, USA.
Snyder
M
Conley
D
Howell
M
Boekeloo
B
Quinn
T
Zenilman
J