Chlamydia screening of at-risk young women in managed health care: characteristics of top-performing primary care offices.
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.
Ray
Midge N
MN
Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama 35294-3361, USA. midgeray@uab.edu
Wall
Terry
T
Casebeer
Linda
L
Weissman
Norman
N
Spettell
Claire
C
Abdolrasulnia
Maziar
M
Mian
M Anwarul Huq
MA
Collins
Blanche
B
Kiefe
Catarina I
CI
Allison
Jeroan J
JJ
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