223736 Missed Opportunities for Chlamydia Screening in Women Aged 15-25

Tuesday, November 9, 2010 : 9:30 AM - 9:50 AM

Sayeedha Uddin, MD, MPH , Division of Health Care Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
Background: Rates of Chlamydia screening in sexually-active women aged 15-25 are low nationally. Previous studies of missed testing opportunities used only single-year data.

Methods: Data from the National Ambulatory Medical Care Survey and the Outpatient Department(OPD) component of the National Hospital Ambulatory Medical Care Survey were used to estimate Chlamydia testing rates in visits by sexually-active women aged 15-25 years from 2005-2007 and, either had no visits in the preceding 12 months, or reported symptoms of Chlamydia infection (by ICD-9 code or reason for visit). Sexually-active women were identified using selected ICD-9 codes or contraception prescription. Rates were estimated by age, race, ethnicity, payment source, ambulatory care setting, metropolitan statistical area, and visit year.

Results: Among women without visits in the preceding 12 months, there were 3.9 million visits to office-based physicians or OPD's; the Chlamydia testing rate was 10.2%. The rate was higher in OPD's compared to physician offices (33.6% vs. 7.7%, p=0.0033). Among women with symptoms, there were 8.1 million visits and the testing rate was 19.5%. Again, the testing rate was higher in the OPD than in physician offices (33.5% vs. 17.6%, p=0.0042). There were no statistically significant differences in testing rates by other patient or provider factors in either subgroup.

Conclusions: While opportunities for testing were missed in a majority of the visits examined, rates appear to be lower in physician offices compared to hospital-based clinics. Increasing Chlamydia testing rates for sexually-active women presenting for ambulatory care could improve the quality of care and women's health.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
1. To quantify missed opportunities for Chlamydia testing during ambulatory visits by sexually-active women aged 15-25 in the United States from 2005-2007. 2. Discuss how testing rates vary with selected provider/practice characteristics. 3. Discuss how testing rates vary with selected patient characteristics.

Keywords: Chlamydia, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a obstetrician/gynecologist who does both operational and analytic work with health care surveys.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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