Is provider continuity associated with chlamydia screening for adolescent and young adult women?
BACKGROUND
Longitudinal patient-provider relationships are a cornerstone of primary care. For many prevention services, better continuity of provider has been associated with better adherence to recommended practice. Our objective was to examine the relationship between continuity of care and chlamydia screening in adolescent and young women, a preventive service where large performance gaps exist.


METHODS
The study population included 4117 sexually active women aged 14-25 years continuously enrolled at a large U.S. HMO. Administrative data from 2000 to 2002 were used to document chlamydia testing, provider continuity, and selected covariates. We used logistic regression to examine the relationship between provider continuity and chlamydia testing after controlling for potential confounders.


RESULTS
57.2% of eligible young women received a chlamydia test over the 2-year period. After controlling for utilization and other confounders, we found women in the lowest continuity of care quartile had 41% greater odds of being tested than those in the highest quartile (OR 1.41, 95% CI 1.14-1.76).


CONCLUSIONS
For adolescents and young women, the likelihood of testing for chlamydia was reduced when care was concentrated with a usual provider. Potential implications for health service delivery are discussed.
Reid
Robert J
RJ
Center for Health Studies, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA. reid.rj@ghc.org
Scholes
Delia
D
Grothaus
Lou
L
Truelove
Yaffa
Y
Fishman
Paul
P
McClure
Jennifer
J
Grafton
Jane
J
Thompson
Robert S
RS
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D014481:United States