Chlamydia Testing Patterns for Commercially Insured Women, 2008

Background Annual chlamydia screening for sexually active women aged ≤25 years is recommended, and chlamydia testing rates have continuously increased. However, several studies have shown that many providers screen all women of reproductive age in public settings. Purpose To examine chlamydia testing patterns in private settings for women and young women aged 15–44 years (hereafter referred to as women). Methods A large commercial claims database was used to estimate the chlamydia testing rate for women aged 15–44 years who had reproductive health services in 2008. Such services and tests were identified using diagnostic and procedural codes in 2008. Results Of 3.2 million women aged 15–44 years who had reproductive health services in 2008, 19.2% had at least a claim for a sexually transmitted disease (STD), 29.3% for pregnancy, and 81.2% for a gynecologic exam. Of those 3.2 million, 22.3% had chlamydia testing: 34.2% aged 15–25 years vs 18.3% aged 26–44 years. Of the 0.7 million who were tested, 65% were aged 26–44 years, and the reason for the healthcare visit in which their first chlamydia test was performed was an STD for 22.7% and pregnancy for 33.5%. Conclusions In this population of insured women, young women are undertested and older women are overtested for chlamydia. Efforts to improve screening practices should be evaluated.