title: Chlamydia screening of at-risk young women in managed health care: characteristics of top-performing primary care offices.
abstract: OBJECTIVE
  Despite effective approaches for managing chlamydial infection, asymptomatic disease remains highly prevalent. We linked administrative data with physician data from the American Medical Association physician survey to identify characteristics of primary care offices associated with best chlamydia screening practices.
  
  
  METHODS
  Criteria from the National Committee for Quality Assurance provided chlamydia screening rates. We defined top-performing offices as those with rates in the top decile among 978 primary care offices from 26 states.
  
  
  RESULTS
  Offices screened an average of 16.2% of at-risk, young women, but top-performing offices screened 42.2%. Top-performing offices on average had more black physicians (12.5%, 5.1%, P = 0.001) and were more often located in zip code areas with median income less than $30,000 (22.6%, 5.5%, P = 0.001).
  
  
  CONCLUSIONS
  Although chlamydia screening rates are alarmingly low overall, there is substantial variation across offices. Understanding predictors of better office performance may lead to effective interventions to promote screening.
authors.affiliation: Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama 35294-3361, USA. midgeray@uab.edu
authors.forename: Midge N
authors.initials: MN
authors.lastname: Ray
authors.forename: Terry
authors.initials: T
authors.lastname: Wall
authors.forename: Linda
authors.initials: L
authors.lastname: Casebeer
authors.forename: Norman
authors.initials: N
authors.lastname: Weissman
authors.forename: Claire
authors.initials: C
authors.lastname: Spettell
authors.forename: Maziar
authors.initials: M
authors.lastname: Abdolrasulnia
authors.forename: M Anwarul Huq
authors.initials: MA
authors.lastname: Mian
authors.forename: Blanche
authors.initials: B
authors.lastname: Collins
authors.forename: Catarina I
authors.initials: CI
authors.lastname: Kiefe
authors.forename: Jeroan J
authors.initials: JJ
authors.lastname: Allison
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002692:Chlamydia trachomatis; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000592:standards; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D014481:United States / Q000453:epidemiology; D014932:Women's Health Services / Q000706:statistics & numerical data