Screening for Chlamydia in Adolescents and Young Women
Rita Mangione-Smith, MD, MPH;
Elizabeth A. McGlynn, PhD;
Liisa Hiatt, MS
Arch Pediatr Adolesc Med. 2000;154:1108-1113.
Objective To measure the proportion of sexually active females aged 15 to 25 years who received a screening test for Chlamydia trachomatis infection during the previous year.
Design Administrative data were used to identify females in the target age range who were likely to be sexually active. Medical record data were reviewed for a sample to determine whether the administrative algorithm was acceptable. Laboratory claims data and medical record data were used to identify females who had had a screening test for chlamydia.
Setting Four geographically dispersed US managed health care plans.
Patients We studied 19,214 sexually active females aged 15 to 25 years continuously enrolled for calendar year 1997 in 1 of 4 major US health plans who had a visit to their health care provider during that year. Sexual activity was determined using an algorithm designed for use with administrative data.
Main Outcome Measure Rates of chlamydia screening among sexually active females aged 15 to 25 years.
Results The proportion of females aged 15 to 25 years identified as sexually active by the administrative data algorithm in the 4 health plans was similar (43%-54%; P = .79). However, substantial variation was found in rates of chlamydia screening for eligible females in these 4 health plans (2%-42%; P<.001). Plans varied considerably in the types of visits (eg, sexually transmitted disease screening or pregnancy) that determined eligibility for the measure.
Conclusions A measure of health plan performance on screening for chlamydia in young females using administrative data is feasible and provides useful results despite some flaws in estimation. There is room for improvement in rates of chlamydia screening in sexually active females aged 15 to 25 years.
From the Department of Pediatrics, University of California, Los Angeles (Dr Mangione-Smith), and the RAND Health Program, Santa Monica, Calif (Dr McGlynn and Ms Hiatt).
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