title: Potential opportunities to enhance syphilis surveillance system.
abstract: BACKGROUND
  The changes in the US health care system during the last decade may have altered the access to and quality of syphilis patient care and syphilis patient data collection.
  
  
  OBJECTIVE
  To identify potential opportunities to enhance syphilis surveillance system.
  
  
  METHODS
  1994-1998 TennCare utilization data regarding primary and secondary syphilis patients matched with the health department confirmed syphilis cases by name, race, and date of birth and audited with the department's clinic data to examine the issues of underreporting, misdiagnosis, and miscoding.
  
  
  RESULTS
  Of 349 patients diagnosed by TennCare providers during 1994-1998, 312 (89.4%) were not matched with the 803 reported cases in the health department surveillance system during the same period.
  
  
  CONCLUSIONS
  A large number of TennCare provider-diagnosed syphilis patients were not known to the health department. Whether it is due to underreporting, miscoding, misdiagnosis, or a combination is unknown. Further investigation offers an avenue to enhance syphilis surveillance system.
authors.affiliation: Metropolitan Health Department of Nashville and Davidson County, TN, USA.
authors.forename: Jianshi
authors.initials: J
authors.lastname: Huang
authors.forename: Stephanie B C
authors.initials: SB
authors.lastname: Bailey
authors.forename: Bart
authors.initials: B
authors.lastname: Perkey
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology; D013714:Tennessee / Q000453:epidemiology