Screening Prevents Disease, Improves Health of Young Women, Chlamydia Study Says

A recent analysis conducted by Kaiser Permanente in partnership with CDC found that by taking simple steps, health care institutions can increase the number of women tested for and diagnosed with chlamydia.

Around 40 percent of women with untreated chlamydia infections develop pelvic inflammatory disease, and 20 percent of those become infertile, according to CDC. Chlamydia-infected patients are also three to five times more likely to acquire HIV if exposed, said CDC. In its 2004 State of Health Care Quality report, the National Committee for Quality Assurance (NCQA) estimated that US health care costs attributable to chlamydia and its consequences exceed $3.5 billion. Cure rates for chlamydia can be achieved at a very low cost of $2-$8.

CDC and several major medical professional associations developed national clinical guidelines that recommend regular chlamydia screening for sexually active young women. In 2000, NCQA developed a new Health Plan Employer Data and Information Set performance measure to determine the proportion of sexually active adolescent and young adult females who are tested annually for chlamydia. Working with CDC, Kaiser Permanente evaluated chlamydia screening policies, testing practices, and the proportion of female patients who were screened in Kaiser's mid-Atlantic region before and after the measure was implemented.

The analysis examined some 75,000 electronic medical records of female Kaiser Permanente members ages 15-26 in the mid-Atlantic states from 1998 to 2001. Over the time period, the screening rate increased by nearly a third. As a result of increased testing, chlamydia diagnoses increased 10 percent. The proportion of the patient populations testing positive remained steady at 8 percent in 1998-1999 and 7 percent in 2000-2001, indicating the high burden of chlamydia in this commercially insured population.

The changes made in the OB/GYN department, where a 42 percent increase in screening was seen over two years -- from 57 percent to 81 percent of eligible women screened -- suggest that systems level changes may have the greatest impact on chlamydia screening.

The full report, "Chlamydia Screening in a Health Plan Before and After a National Performance Measure Introduction," was published in Obstetrics & Gynecology (2005;106:327-334).

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