P143 Importance of Physicians in Chlamydia Trachomatis and Neisseria Gonorrhoeae Control

Tuesday, March 9, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Wiley Jenkins, PhD, MPH, Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, IL and Charlie Rabins, MPH, STD Section, Illinois Department of Public Health, Springfield, IL

Background: During 2002-2006, reported rates of chlamydia (CT) increased 11.4% in Illinois and 17.3% nationally. Gonorrhea (GC) rates decreased overall during that time, but increased in both Illinois and nationally 2005-2006. USPSTF guidelines that sexually active females aged <25 be screened annually for CT were followed for only 30.2% of eligible females enrolled in managed care plans in Illinois in 2006 (HEDIS). Untreated cases often lead to significant morbidity and cost, estimated at $2.5 billion annually.

Objectives: We sought to determine the relative importance (measured by proportion of cases identified) of clinicians as screening providers with respect to other provider types in Illinois, and if this importance varied by county population as classified by their Rural-Urban Continuum  (RUC) code.

Methods: A retrospective analysis of all CT and GC cases reported in Illinois during 2002-2006. Counties were stratified by their RUC code (1-9). Eighteen different provider types were condensed into ten categories.

Results: Private physicians and hospitals identified 58.5% of the 247,725 reported CT cases (33.1% and 25.4%, respectively), and 59.1% of the 106,645 reported GC cases (24.7% and 34.4%). Physicians were the greatest source of reported CT cases for counties with RUC codes 1-8, and of GC cases in RUC codes 4-7 and 9. Hospitals were the greatest source of GC cases in RUC 1 and 3, the second greatest in RUC 2, 4-6 and 8, and second greatest of CT in RUC 1.  

Conclusions: The data show that even though screening guidelines compliance is low, physicians and hospitals still identify the majority of CT and GC cases in Illinois and are consistently important screening providers at all levels of population.

Implications for Programs, Policy, and/or Research: Health department officials should actively engage local physicians and hospitals in CT/GC intervention efforts and encourage knowledge of, and compliance with, screening guidelines.

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