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STD-4.1 Data Details

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STD-4.1 Increase the proportion of sexually active females aged 16 to 20 years enrolled in commercial health insurance plans who are screened for genital Chlamydia infections during the measurement year

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
Healthcare Effectiveness Data and Information Set
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
40.1 (2008)
Target: 
61.3
Target-Setting Method: 
Projection/trend analysis
Target-Setting Method Justification: 
Linear regression was conducted on Healthcare Effectiveness Data and Information Set (HEDIS) data from 1999 to 2009 for each age group and type of plan. Linear regression modeling estimated that if screening increases continued at the same rate, the rate for 16- to 20-year-olds enrolled in commercial health insurance plans would be 61.3 percent by 2020. Screening rates are not expected to exceed the rates of other reproductive health screenings. Cervical cancer screening has the highest screening rate of a reproductive health service as measured by HEDIS. The Pap test screening rate has been approximately 80 percent since 2000. The target is consistent with the National Prevention Strategy.
Numerator: 

Number of women 16-20 years of age who were identified as eligible in the denominator and who had at least one test for Chlamydia during the measurement year

Denominator: 

Number of women 16-20 years of age who were identified as sexually active and who had no more than one gap in enrollment of up to 45 days during the measurement year

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Methodology Notes: 

    Chlamydia trachomatis infection is the most common bacterial sexually transmitted disease (STD) in the United States. Untreated Chlamydia can progress to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. The Centers for Disease Control and Prevention (CDC) estimates that every year, undiagnosed and untreated STDs cause at least 24,000 women in the United States to become infertile.

    HEDIS is a widely-used set of performance measures in the managed-care industry, developed and maintained by NCQA. Annual data on Chlamydia screening rates, measured by the proportion of sexually active women aged 15-25 who received at least one Chlamydia test in the measurement year, have been collected in HEDIS since 2000. Screening rates for Medicaid health plans became available in 2001. In 2008, the upper age limit was changed from 25 to 24.

    Because of the silent nature of Chlamydia infections, routine screening in clinical and non-clinical settings is the cornerstone of effective STD-related infertility prevention. The HEDIS Chlamydia screening measure is a valuable indicator of commercial and Medicaid health plans’ progress toward increasing the proportion of sexually active women under 25 years of age who are screened at least annually for Chlamydia infections. This is especially important, as the majority of Chlamydia infections are reported from the private sector. The HEDIS data set provides information from health maintenance organizations (HMO) and point-of-service plans (POS).

Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 25-16a in that objective 25-16a addressed Chlamydia screening among women aged 16 to 25 years enrolled in commercial health insurance plans. For Healthy People 2020, the upper age limit was reduced to 24 years and the age category was split into two groups: 16 to 20 years and 21 to 24 years. This objective addresses Chlamydia screening among women aged 16 to 20 years enrolled in commercial plans.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
The target was revised in 2013 from 65.9 percent to 61.3 percent due to a calculation error.