Screening for chlamydia in adolescents and young women.
OBJECTIVE
To measure the proportion of sexually active females aged 15 to 25 years who received a screening test for Chlamydia trachomatis infection during the previous year.


METHODS
Administrative data were used to identify females in the target age range who were likely to be sexually active. Medical record data were reviewed for a sample to determine whether the administrative algorithm was acceptable. Laboratory claims data and medical record data were used to identify females who had had a screening test for chlamydia.


METHODS
Four geographically dispersed US managed health care plans.


METHODS
We studied 19,214 sexually active females aged 15 to 25 years continuously enrolled for calendar year 1997 in 1 of 4 major US health plans who had a visit to their health care provider during that year. Sexual activity was determined using an algorithm designed for use with administrative data.


METHODS
Rates of chlamydia screening among sexually active females aged 15 to 25 years.


RESULTS
The proportion of females aged 15 to 25 years identified as sexually active by the administrative data algorithm in the 4 health plans was similar (43%-54%; P =.79). However, substantial variation was found in rates of chlamydia screening for eligible females in these 4 health plans (2%-42%; P<. 001). Plans varied considerably in the types of visits (eg, sexually transmitted disease screening or pregnancy) that determined eligibility for the measure.


CONCLUSIONS
A measure of health plan performance on screening for chlamydia in young females using administrative data is feasible and provides useful results despite some flaws in estimation. There is room for improvement in rates of chlamydia screening in sexually active females aged 15 to 25 years.
Mangione-Smith
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RAND Health Program, 1700 Main St, PO Box 2138, Santa Monica, CA 90407-2138, USA.
McGlynn
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Hiatt
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D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D006293:Health Promotion; D006801:Humans; D008403:Mass Screening; D011247:Pregnancy; D015203:Reproducibility of Results; D012725:Sexual Behavior; D014481:United States / Q000453:epidemiology