Abstract: Making the Most of Less: Collaborative Targeting of Chlamydia Tests When the Budget Requires Rationing (2010 National STD Prevention Conference)

Thursday, March 11, 2010: 9:30 AM

International Ballroom B/C (M2) (Omni Hotel)

Barbara Conrad, BSN, RN, MPH¹, César Peña, DVM, MHS¹, Sandra Matus, MPH¹, Anne Rompalo, MD, ScM², Maria Paz Carlos, PhD³ and Robert Myers, PhD³, 1Center for STIs, TB and Immigrant Health, Office of Infectious Disease Prevention and Care Services, Maryland Department of Health and Mental Hygiene, Baltimore, MD, 2School of Medicine, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, 3MD DHMH Laboratories Administration, MD DHMH Laboratories Administration, Baltimore, MD

Audio File Recorded presentation

Background: The State Laboratory upgraded from ELISA antigen capture assay to Nucleic Acid Amplification based testing,the accepted standard of laboratory practice for Chlamydia screening. However there were no additional funds to accommodate increased reagent costs. A system to reduce test volumes for local health departments by 50% had to be developed and implemented between the August 2008 announcement of impending change and the February 2009 start date

Objectives: To describe the processes used to develop new Chlamydia testing guidelines to conform to severely reduced test volumes and improve targeting.

Methods: The Chlamydia Allocation Taskforce was formed with representation from STI, Family Planning, State Laboratory, and local health departments. Intensive data analysis included review of gender, age and positivity at site level for over 200 sites and type of visit in Family Planning clinics. The STI and Family Planning Medical Consultants established common clinical priorities for testing. Local health departments STD and Family Planning programs collaborated to determine the allocation of tests to sites and which sites would be excluded from participation altogether. The State Laboratory developed a sticker tracking system for approved tests, and now provides monthly reports to health departments. Quarterly analysis gives feedback re gender, age and positivity of tested individuals. Local Health Officers were involved throughout the process

Results: Local health department STD and Family Planning divisions successfully collaborated to identify local priorities. Targeting of tests improved, as shown by increased positivity and reduced volumes of testing in lower priority populations

Conclusions: Local health department STD and Family Planning divisions successfully collaborated to identify local priorities. Targeting of tests improved, as shown by increased positivity and reduced volumes of testing in lower priority populations

Implications for Programs, Policy, and/or Research: Other state and local health departments may consider this model when faced with their own budgetary restrictions for Chlamydia testing

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D2e Making the Most of Less: Collaborative Targeting of Chlamydia Tests When the Budget Requires Rationing