Screening for chlamydia in adolescents and young women

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 revi ewed for a sample to determine whether the administrative algorithm was acc eptable. Laboratory claims data and medical record data were used to identi fy 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 con tinuously enrolled for calendar year 1997 in 1 of 4 major US health plans w ho had a visit to their health care provider during that year. Sexual activ ity was determined using an algorithm designed for use with administrative data. Main Outcome Measure: Rates of chlamydia screening among sexually active fe males aged 15 to 25 years. Results: The proportion of females aged 15 to 25 years identified as sexual ly active by the administrative data algorithm in the 4 health plans was si milar (43%-54%; P=.79). However, substantial variation was found in rates o f chlamydia screening for eligible females in these 4 health plans (2%-42%; P<.001). Plans varied considerably in the types of visits leg, sexually tr ansmitted disease screening or pregnancy) that determined eligibility for t he measure. Conclusions: A measure of health plan performance on screening for chlamydi a in young females using administrative data is feasible and provides usefu l results despite some flaws in estimation. There is room for improvement i n rates of chlamydia screening in sexually active females aged 15 to 25 yea rs.