Innovative Prevalence Monitoring through Private Sector Collaboration-Part Two

Background:  Interpretation of case-based chlamydia and gonorrhea (CT/NG) STD surveillance data can be challenging without supplemental information about the at-risk population, including characteristics of who is seeking care, getting tested, and proportion testing positive.  Sentinel clinic-based prevalence monitoring of chlamydia and gonorrhea is one model for collecting supplemental information, and has focused on high priority populations in public sector clinics, e.g. STD, family planning, and correctional settings.  To construct a more representative profile of local STD burden among the vast majority of the population seeking care in the private sector, access to population-based program data sources in the private sector should be considered.   

 Objective:  Identify private sector data sources with clinical and laboratory data that can be shared with local public health STD surveillance agencies for assessment of STD-related care, development of cost-efficient screening guidelines, and evaluation of preventable STD-related outcomes.

Methods:  To assess age-specific CT/NG screening coverage at the program and provider level, we analyzed Family PACT program administrative client enrollment and provider claims data from 2003-2012.  To assess CT/NG prevalence rates, we merged Quest Diagnostics data with the administrative data to determine relative case yields by age.  We will also present examples of other CT/NG prevalence monitoring efforts based on Kaiser Permanente Northern California (KPNC) chlamydia and gonorrhea data, and national/state-level Lab Corp data. To estimate the burden of pelvic inflammatory disease, we used Family PACT claims-based ICD-9/NDC/CPT4 codes, as well as KPNC PID clinical encounter data, and present examples of other approaches with Group Health Cooperative and Market Scan data sources.

Results: CT/NG screening rates have increased across all data sources and all age groups.  CT/NG prevalence monitoring trends across administrative data sources from multiple private sector data sources demonstrate similar and consistent age and race disparities to those seen in case-based surveillance data.  Administrative data-based PID burden exceeds that seen in mandated case reports but for some sources showed declining trends coincident with increases in screening coverage.   

Conclusions:  Analysis of program-specific and population-based administrative data on STD-related clinical and laboratory data have been very useful for targeting programs and providers to improve cost-efficient screening of young women, reduce over-screening in low prevalence populations, and demonstrate impact of increased access to STD services on reduced reproductive sequelae. Background: