title: Healthcare utilization by women in a comprehensive managed care population subsequent to diagnosis of a sexually transmitted disease.
abstract: BACKGROUND
  Healthcare utilization (HCU) following a sexually transmitted disease (STD) diagnosis is poorly characterized.
  
  
  OBJECTIVE
  The goal was to quantify HCU for new/recurrent STDs and other relevant Ob-Gyn and mental health problems in the 18 months subsequent to an STD diagnosis.
  
  
  METHODS
  We compared HCU between a group of females aged 18 to 45 years who were Kaiser Permanente Medical Program members with a diagnosed STD (n = 1,205) and a medical center- and age group-matched sample of women seen for a non-STD diagnosis in the same time period (n = 4820), with controlling where appropriate for age, medical center, and chronic disease status.
  
  
  RESULTS
  An STD diagnosis was associated with significantly greater likelihood of subsequent visits for STDs (relative risk [RR] = 3.8), pelvic inflammatory disease/endometritis (RR = 2.9), candidiasis (RR = 2.0), vaginitis (RR = 2.4), cervical dysplasia (RR = 1.7), menstrual disorders/abnormal bleeding (RR = 1.3), high risk/complicated/ectopic pregnancy (RR = 1.5), and behavioral/mental health problems (RR = 1.3) than for women seen for a non-STD diagnosis.
  
  
  CONCLUSIONS
  Detrimental sequelae of STDs are reflected in substantially elevated near-term HCU following an STD diagnosis.
authors.affiliation: Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California 94301, USA. wilsons@pamfri.org
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Wilson
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Brown
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Leyden
authors.forename: M Michele
authors.initials: MM
authors.lastname: Manos
authors.forename: Victor
authors.initials: V
authors.lastname: Chin
authors.forename: David
authors.initials: D
authors.lastname: Levin
authors.forename: Paula
authors.initials: P
authors.lastname: Braverman
authors.forename: Stanley
authors.initials: S
authors.lastname: Shapiro
authors.forename: Philip W
authors.initials: PW
authors.lastname: Lavori
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003191:Comprehensive Health Care / Q000706:statistics & numerical data*; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology