The consistency of relative incidence rates of nonviral sexually transmissible infections from health insurance claims and surveillance data, 2005–10
Kwame Owusu-Edusei
+ Author Affiliations
- Author Affiliations
A Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-80, Atlanta, GA 30333, USA.
B Corresponding author. Email: Kowusuedusei@cdc.gov
Sexual Health 10(5) 400-407 https://doi.org/10.1071/SH12191
Submitted: 5 November 2012 Accepted: 19 May 2013 Published: 15 July 2013
Abstract
Background: Given the growing popularity of administrative data for health research, information on the differences and similarities between administrative data and customary data sources (e.g. surveillance) will help to inform the use of administrative data in the field of sexually transmissible infections (STIs). The objective of this study was to compare the incidence rates of three nonviral STIs from a large health insurance administrative database (MarketScan) with surveillance data. Methods: We computed and compared STI rates for 2005–10 from MarketScan and national surveillance data for three major nonviral STIs (i.e. chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and syphilis (Treponema pallidum)). For administrative data, we assessed the sensitivity of the rates to enrolee inclusion criteria: continuous (≥320 member-days) versus all enrolees. Relative rates were computed for 5-year age groups and by gender. Results: The administrative database rates were significantly lower (P < 0.01) than those in the national surveillance data, except for syphilis in females. Gonorrhoea and syphilis rates based on administrative data were significantly lower (P < 0.01) for all enrolees versus continuous enrolees only. The relative STI rates by age group from the administrative data were similar to those in the surveillance data. Conclusions: Although absolute STI rates in administrative data were lower than in the surveillance data, relative STI rates from administrative data were consistent with national surveillance data. For gonorrhoea and syphilis, the estimated rates from administrative data were sensitive to the enrolee inclusion criteria. Future studies should examine the potential for administrative data to complement surveillance data.
Additional keywords: chlamydia, claims data, gonorrhoea, syphilis.
References
[1] Satterwhite CL, Torrone E, Meitis E, Dunne EF, Mahajan R, Ocfemia MCB, et al Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008. Sex Transm Dis 2013; 40 187–93.| Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008.Crossref | GoogleScholarGoogle Scholar | 23403598PubMed |
[2] Owusu-Edusei K, Chesson HW, Gift TL, Tao G, Ocfemia MCB, Mahajan R, et al The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sex Transm Dis 2013; 40 197–201.
| The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008.Crossref | GoogleScholarGoogle Scholar | 23403600PubMed |
[3] Eng T, Butler W, eds. The hidden epidemic: confronting sexually transmitted diseases. Washington DC: Institute of Medicine, National Academy Press; 1997.
[4] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2011. Atlanta: US Department of Health and Human Services; 2012.
[5] Virnig BA, McBean M. Administrative data for public health surveillance and planning. Annu Rev Public Health 2001; 22 213–30.
| Administrative data for public health surveillance and planning.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7os1Ogsw%3D%3D&md5=25d7de38ed7b4e3ad14eef75d794ad9bCAS | 11274519PubMed |
[6] Wennberg J. Gittelsohn A. Small area variations in health care delivery. Science 1973; 182 1102–8.
| Gittelsohn A. Small area variations in health care delivery.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE2c%2Fis1Sjtw%3D%3D&md5=918c5f273de5c629facb4aacb4250eecCAS | 4750608PubMed |
[7] McGlynn EA, Kerr EA, Asch SM. New approach to assessing clinical quality of care for women: the QA Tool system. Womens Health Issues 1999; 9 184–92.
| New approach to assessing clinical quality of care for women: the QA Tool system.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1Mzjtl2kug%3D%3D&md5=cd75cafb74d74063e737eae86a1ec6f5CAS | 10405590PubMed |
[8] Truven Health Analytics. MarketScan research database: user guide and database dictionary. Ann Arbor: Truven Health Analytics; 2009.
[9] DeNavas-Walt C, Proctor DB, Smith JC, United States Census Bureau. Income, poverty, and health insurance coverage in the United States: 2011. Current population reports, P60–243. Washington DC: US Government Printing Office; 2012.
[10] Owusu-Edusei K, Bohm MK, Kent CK. Diagnostic methodologies for chlamydia screening in females aged 15 to 25 years from private insurance claims data in the United States, 2001 to 2005. Sex Transm Dis 2009; 36 419–21.
| Diagnostic methodologies for chlamydia screening in females aged 15 to 25 years from private insurance claims data in the United States, 2001 to 2005.Crossref | GoogleScholarGoogle Scholar | 19556935PubMed |
[11] Owusu-Edusei K, Doshi SR, Apt BS, Gift TL. The direct cost of chlamydial infections: estimates for the employer-sponsored privately insured population in the United States, 2003–2007. Sex Transm Dis 2010; 37 519–21.
| 20414145PubMed |
[12] Owusu-Edusei K, Gift TL, Chesson HW. Treatment cost of acute gonococcal infections: estimates from employer-sponsored private insurance claims data in the United States, 2003–2007. Sex Transm Dis 2010; 37 316–8.
| 20216479PubMed |
[13] Owusu-Edusei K, Hoover KW, Tao G. Estimating the direct outpatient medical cost per episode of primary and secondary syphilis in the United States: insured population perspective, 2003–2007. Sex Transm Dis 2011; 38 175–9.
| Estimating the direct outpatient medical cost per episode of primary and secondary syphilis in the United States: insured population perspective, 2003–2007.Crossref | GoogleScholarGoogle Scholar | 20871492PubMed |
[14] Gift TL, Owens CJ. The direct medical cost of epididymitis and orchitis: evidence from a study of insurance claims. Sex Transm Dis 2006; 33 S84–8.
| The direct medical cost of epididymitis and orchitis: evidence from a study of insurance claims.Crossref | GoogleScholarGoogle Scholar | 17003682PubMed |
[15] Bohm MK, Newman L, Satterwhite CL, Tao G, Weinstock HS. Pelvic inflammatory disease among privately insured women, United States, 2001–2005. Sex Transm Dis 2010; 37 131–6.
| Pelvic inflammatory disease among privately insured women, United States, 2001–2005.Crossref | GoogleScholarGoogle Scholar | 20051931PubMed |
[16] Heijne JC, Tao G, Kent CK, Low N. Uptake of regular chlamydia testing by U.S. women: a longitudinal study. Am J Prev Med 2010; 39 243–50.
| Uptake of regular chlamydia testing by U.S. women: a longitudinal study.Crossref | GoogleScholarGoogle Scholar | 20709256PubMed |
[17] Hoover KW, Tao G, Berman S, Kent CK. Utilization of health services in physician offices and outpatient clinics by adolescents and young women in the United States: implications for improving access to reproductive health services. J Adolesc Health 2010; 46 324–30.
| Utilization of health services in physician offices and outpatient clinics by adolescents and young women in the United States: implications for improving access to reproductive health services.Crossref | GoogleScholarGoogle Scholar | 20307820PubMed |
[18] Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol 2010; 115 495–502.
| Trends in the diagnosis and treatment of ectopic pregnancy in the United States.Crossref | GoogleScholarGoogle Scholar | 20177279PubMed |
[19] Owusu-Edusei K, Bohm MK, Chesson HW, Kent CK. Chlamydia screening and pelvic inflammatory disease: insights from exploratory time-series analyses. Am J Prev Med 2010; 38 652–7.
| Chlamydia screening and pelvic inflammatory disease: insights from exploratory time-series analyses.Crossref | GoogleScholarGoogle Scholar | 20494242PubMed |
[20] Tao G, Hoover KW. Kent CK. Chlamydia testing patterns for commercially-insured females aged 15–44 years in 2008. Am J Prev Med 2012; 42 337–41.
| Kent CK. Chlamydia testing patterns for commercially-insured females aged 15–44 years in 2008.Crossref | GoogleScholarGoogle Scholar | 22424245PubMed |
[21] Tao G, Hoover KW, Kent CK. 2009 cervical cytology guidelines and chlamydia testing among sexually active young women. Obstet Gynecol 2010; 116 1319–23.
| 2009 cervical cytology guidelines and chlamydia testing among sexually active young women.Crossref | GoogleScholarGoogle Scholar | 21099597PubMed |
[22] Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS technical specifications. Washington DC: National Committee for Quality Assurance; 2008.
[23] Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev 1995; 8 1–21.
| 1:STN:280:DyaK2M3hvFyhtg%3D%3D&md5=dca0ad2257403dfdbb884eee95100521CAS | 7704889PubMed |
[24] Larsen SA, Pope V, Johnson RE, Kennedy EJ, eds. A manual of tests for syphilis. Ninth edn. Arlington: American Public Health Association; 1998.
[25] US Preventive Services Task Force. Guide to clinical preventive services. Second edn. Washington, DC: Office of Disease Prevention and Health Promotion; 1996.
[26] Adimora AA, Schoenbach VJ. Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. J Infect Dis 2005; 191 S115–22.
| Social context, sexual networks, and racial disparities in rates of sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar | 15627221PubMed |
[27] Aral SO, Holmes KK. The epidemiology of STIs and their social and behavioral determinants: Industrilized and developing countries. In Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, et al., eds. Sexually transmitted diseases. New York: McGraw Hill; 2008. pp. 53–92.
[28] Centers for Medicare & Medicaid Services (CMMS). Medicaid. Baltimore: CMMS; 2013. Available online at: http://www.medicare. gov/your-medicare-costs/help-paying-costs/medicaid/medicaid.html [verified March 2013].
[29] Centers for Disease Control and Prevention (CDC). Sexually transmitted disease treatment guidelines, 2010. Atlanta: CDC; 2011.
[30] Owusu-Edusei K, Nguyen HT, Gift TL. Utilization and cost of diagnostic methods for sexually transmitted infection screening among insured American youth, 2008. Sex Transm Dis 2013; 40 354–61.
| Utilization and cost of diagnostic methods for sexually transmitted infection screening among insured American youth, 2008.Crossref | GoogleScholarGoogle Scholar | 23588123PubMed |
[31] Henderson T, Shepheard J, Sundararajan V. Quality of diagnosis and procedure coding in ICD-10 administrative data. Med Care 2006; 44 1011–9.
| Quality of diagnosis and procedure coding in ICD-10 administrative data.Crossref | GoogleScholarGoogle Scholar | 17063133PubMed |
[32] Peabody JW, Luck J, Jain S, Bertenthal D, Glassman P. Assessing the accuracy of administrative data in health information systems. Med Care 2004; 42 1066–72.
| Assessing the accuracy of administrative data in health information systems.Crossref | GoogleScholarGoogle Scholar | 15586833PubMed |
[33] Grimes DA. Epidemiologic research using administrative databases: garbage in, garbage out. Obstet Gynecol 2010; 116 1018–9.
| Epidemiologic research using administrative databases: garbage in, garbage out.Crossref | GoogleScholarGoogle Scholar | 20966682PubMed |
[34] Hoover KW, Tao G, Kent CK, Aral SO. Epidemiologic research using administrative databases: garbage in, garbage out. Obstet Gynecol 2011; 117 729
| 21343778PubMed |
