title: Providing Mailing Cost Reimbursements: The Effect on Reporting Timeliness of Sexually Transmitted Diseases in Virginia.
abstract: OBJECTIVE
  We investigated the effect of providing mailing cost reimbursements to local health departments on the timeliness of the reporting of sexually transmitted diseases (STDs) in Virginia.
  
  
  METHODS
  The Division of Disease Prevention, Virginia Department of Health, provided mailing cost reimbursements to 31 Virginia health districts from October 2002 to December 2004. The difference (in days) between the diagnosis date (or date the STD paperwork was initiated) and the date the case/STD report was entered into the STD surveillance database was used in a negative binomial regression model against time (as divided into three periods-before, during, and after reimbursement) to estimate the effect of providing mailing cost reimbursements on reporting timeliness.
  
  
  RESULTS
  We observed significant decreases in the number of days between diagnosis and reporting of a case, which were sustained after the reimbursement period ended, in 25 of the 31 health districts included in the analysis. We observed a significant initial decrease (during the reimbursement period) followed by a significant increase in the after-reimbursement phase in one health district. Two health districts had a significant initial decrease, while one health district had a significant decrease in reporting timeliness in the period after reimbursement. Two health districts showed no significant changes in the number of days to report to the central office.
  
  
  CONCLUSIONS
  Providing reimbursements for mailing costs was statistically associated with improved STD reporting timeliness in almost all of Virginia's health districts. Sustained improvement after the reimbursement period ended is likely indicative of improved local health department reporting habits.
authors.affiliation: Office of Epidemiology, Division of Disease Prevention, Virginia Department of Health, Richmond, VA.
authors.forename: Oana E
authors.initials: OE
authors.lastname: Vasiliu
authors.affiliation: Office of Epidemiology, Division of Disease Prevention, Virginia Department of Health, Richmond, VA; Department of Epidemiology and Community Health, School of Medicine, Virginia Commonwealth University, Richmond, VA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Stover
authors.affiliation: Office of Epidemiology, Division of Disease Prevention, Virginia Department of Health, Richmond, VA; Health Management Corporation, Richmond, VA.
authors.forename: Marissa J E
authors.initials: MJ
authors.lastname: Mays
authors.affiliation: Office of Epidemiology, Division of Disease Prevention, Virginia Department of Health, Richmond, VA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Bissette
authors.affiliation: Office of Epidemiology, Division of Disease Prevention, Virginia Department of Health, Richmond, VA; Williamsburg Community Health Foundation, Williamsburg, VA.
authors.forename: Carrie B
authors.initials: CB
authors.lastname: Dolan
authors.affiliation: Department of Epidemiology, Michigan State University, East Lansing, MI.
authors.forename: Corina M
authors.initials: CM
authors.lastname: Sirbu