Chlamydia testing patterns for commercially insured women, 2008

Abstract

Background: Annual chlamydia screening for sexually active women aged ≤25 years is recommended, and chlamydia testing rates have continuously increased. However, several studies have shown that many providers screen all women of reproductive age in public settings.

Purpose: To examine chlamydia testing patterns in private settings for women and young women aged 15-44 years (hereafter referred to as women).

Methods: A large commercial claims database was used to estimate the chlamydia testing rate for women aged 15-44 years who had reproductive health services in 2008. Such services and tests were identified using diagnostic and procedural codes in 2008.

Results: Of 3.2 million women aged 15-44 years who had reproductive health services in 2008, 19.2% had at least a claim for a sexually transmitted disease (STD), 29.3% for pregnancy, and 81.2% for a gynecologic exam. Of those 3.2 million, 22.3% had chlamydia testing: 34.2% aged 15-25 years vs 18.3% aged 26-44 years. Of the 0.7 million who were tested, 65% were aged 26-44 years, and the reason for the healthcare visit in which their first chlamydia test was performed was an STD for 22.7% and pregnancy for 33.5%.

Conclusions: In this population of insured women, young women are undertested and older women are overtested for chlamydia. Efforts to improve screening practices should be evaluated.