title: Is out-of-pocket cost a barrier to receiving repeat tests for chlamydia and gonorrhoea?
abstract: We aimed to examine whether out-of-pocket (OOP) costs associated with chlamydia (CT) and gonorrhoea (GC) screening tests is a barrier to receiving CT/GC re-screening and follow-up annual screening. A major health insurance claims database 2006-2010 was used for analysis. The date of first CT/GC diagnosis was used as the index date, and OOP costs at index date for screening tests were retrieved. A re-screening test and an annual screening were defined as tests that occurred within 90-180 days and 181-395 days of the index date, respectively. Re-screening rates were 11.7% and 10.9% and annual screening rates were 24.7% and 23.7% for CT and GC cases, respectively. Compared with the CT patients without OOP expenses, those with OOP expenses of $30 or higher had significantly reduced likelihood of receiving re-screening and annual screening. Similar results were found for GC patients. We concluded that OOP costs serve as a significant barrier to re-screening and annual screening.
authors: Department of Global Health Systems and Development, School of Public Health and Tropical Medicine,Tulane University, New Orleans, LA, USA. lshi1@tulane.edu
authors: L
authors: L
authors: Shi
authors: Y
authors: Y
authors: Xie
authors: J
authors: J
authors: Liu
authors: P
authors: P
authors: Kissinger
authors: M
authors: M
authors: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis / Q000191:economics; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003669:Deductibles and Coinsurance / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D006069:Gonorrhea / Q000175:diagnosis / Q000191:economics; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D010342:Patient Acceptance of Health Care; D014481:United States; D055815:Young Adult
keywords: STIs; chlamydia; follow-up annual screening; gonorrhoea; out-of-pocket cost; re-screening; sexually transmitted infections