C-B1-04: Piloting Use of the HMO Research Network Virtual Data Warehouse for Pelvic Inflammatory Disease Surveillance and Research

Abstract

Background/AimsNational surveillance for pelvic inflammatory disease (PID) has been problematic for some time, as treatment and practice patterns have shifted away from inpatient settings and surgical procedures. Research and surveillance may be enhanced by use of automated data now available in many health plans. We evaluated the use of the HMO Research Network (HMORN) Virtual Data Warehouse (VDW) at two sites (GH and KPCO) to compare rates and 9-year trends in PID. As part of these evaluations, we explored the feasibility of using the VDW to obtain related chlamydia testing and infection information.MethodsUsing standard ICD-9 codes for PID, we identified all cases occurring among GH women aged 15?44 years during 2000?2008. We then modified these programs for use by other HMORN sites by applying the VDW data dictionary standard variable naming conventions. We piloted these programs at KPCO. We calculated annual PID rates per 100,000 person years by 5-year age groups. We also sought information on chlamydia testing and test result within 7 days of the coded PID diagnosis date. The VDW includes relevant CPT codes for chlamydia testing, but microbiology test results are currently unavailable. Therefore, each site accessed their respective lab databases and used agreed-upon text strings to extract test result data.ResultsPID rates were lower at KPCO than at GH. From 2000?2008, there were no significant PID linear trends at either plan. At GH, the rate was 562/100,000 person-years in 2000 and 526/100,000 in 2008; at KPCO, rates were 532/100,000 in 2000 and 485/100,000 in 2008. PID rates declined significantly only in the 20?24 year-old age group at KPCO. The proportion of cases receiving inpatient treatment was low (8%?16%). At both sites, approximately one-half of PID cases had evidence of chlamydia testing within 7 days.ConclusionsGiven the national surveillance challenges for PID, the HMORN VDW is a potentially valuable resource that can add to PID surveillance and research by providing standardized data from multiple health plans across the U.S. With some expansion, the VDW could include additional information on characteristics of infection and aspects of care that have not previously been widely available.