Management of urethritis in health maintenance organization members receiving care at a multispecialty group practice in Massachusetts

Background: Cost containment has led to a concern that health maintenance o rganization-insured patients presenting with complaints of urethritis may b e treated without being tested. Goal: To determine the proportion of men presenting with symptoms of urethr itis who are tested for Chlamydia trachomatis and Neisseria gonorrhoeae. Study Design: Reviews were performed on 196 randomly selected patient recor ds with an outpatient visit and a diagnostic code consistent with urethriti s between 1995 and 1997. Data were collected on demographics, diagnostic te sting, and treatment. Results: Diagnostic testing for C trachomatis and N gonorrhoeae was perform ed, respectively, in 92.3% and 83.2% of the men presenting at an initial vi sit with complaints of urethritis. Altogether, 98.2% of the patients who me t the Centers for Disease Control criteria for documenting urethritis were tested for C trachomatis and N gonorrhoeae. Conclusion: Diagnostic testing for C trachomatis and N gonorrhoeae is nearl y universal in this multispecialty group practice setting, facilitating sur veillance and public health efforts.