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Understanding sexual activity defined in the HEDIS measure
of screening young women for Chlamydia trachomatis.
The Joint Commission Journal on Quality Improvement 2002;28(8):435-40.
Tao G, Walsh CM, Anderson LA, Irwin KL.
Abstract
BACKGROUND: Periodic screening of sexually active young women for Chlamydia
trachomatis is widely recommended and is now monitored in the Health Plan
Employer Data and Information Set (HEDIS). Because little is known about
how well the HEDIS measure identifies sexually active women eligible for
screening, rates of sexual activity as defined by the measure's specifications
were compared with those derived from self-reported sexual behavior and use
of sexual health services among privately insured women. METHODS: Using the
1996 MarketScan claims data for privately insured women aged 15-25 years,
a measure of sexual activity based on the HEDIS specifications for sexual
activity was calculated, that is, claims for Pap tests and pelvic examinations,
contraceptive services, pregnancy-related service, and screening and treatment
for sexually transmitted diseases. RESULTS: For privately insured women 15-25
years of age, the sexual activity rate was estimated to be 27% based on the
HEDIS algorithm using the MarketScan claims data and 60% based on self-reported
sexual behavior or 62% based on self-reported use of sexual health services
using the 1995 National Survey of Family Growth (NSFG) data. DISCUSSION:
Among young, privately insured women, use of claims specified by HEDIS classifies
a smaller proportion of young women as sexually active than does use of self-reported
survey data on sexual behavior or use of sexual health services. If HEDIS
continues to rely on claims data because it is easier or less costly to collect
and analyze than survey data, users of this performance measure should be
aware that it may underestimate the number of women who are eligible for
this screening benefit.