Abstract
Gonorrhea is the second most commonly reported bacterial STD, most of which is diagnosed in the private sector. STD treatment guidelines suggest retesting people with gonorrhea 3 months post treatment. The objective was to examine the rate and predictors of re-testing within 3-6 months among privately insured patients (15-50 years) diagnosed with gonorrhea. A commercial insurance database was used to extract patients with gonorrhea (ICD-9-CM codes: 98.xx) in year 2007-2009. The date of first gonorrhea diagnosis was used as the index date. Patients were required to have health insurance >= 6 months before and after the index date. We also defined the re-screening service for gonorrhea by using the CPT codes: 87081, 87205, 87590, 87591, 87492, 87800, and 87801 within 3-6 months after the index date. Logistic regression model was used to identify factors affecting the likelihood of gonorrhea retesting. Among 1016 persons diagnosed with gonorrhea, about 48% were in the age group 15-25 years, 36% in 25-40 years, and 16% in 40-50 years. The majority were women (61.4%). Only 110/1016 (10.8%) patients were rescreened within 3-6 months. The re-screening rates in 2007, 2008, and 2009 were 6.1%, 11.6%, and 13.7%, respectively. The re-screened individuals were more likely to be: women but not pregnant (OR=1.93, 95% CI: 1.20-3.12), pregnant women (OR=4.46, 95% CI: 2.17-9.19), compared to men; age 15-25 years old (OR=2.65, 95% CI=1.17-6.00) and 25-40 years old (OR=2.65, 95% CI: 1.15-6.09), compared to age 40-50 years old; and those diagnosed in 2008 (OR=2.11, 95% CI: 1.15-3.85) and 2009 (OR=2.44, 95% CI: 1.28-4.66), compared to 2007. While rescreening rates are increasing among privately insured patients diagnosed with gonorrhea, they are still very low. To improve rescreening rate, policy makers should urgently consider policy options including rescreening of all gonorrhea cases for effective control of the disease.
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