Estimating prenatal syphilis and HIV screening rates for commercially insured women

Tao, Guoyu; Patterson, E. A.; Lee, Lisa M.; Sansom, Stephanie L.; Teran, Silvia; Irwin, Kathleen L.

doi:10.1016/j.amepre.2004.09.001

Cited by 16 publications

(5 citation statements)

References 12 publications

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“…There is currently no national surveillance for CMV infection or disease among pregnant women or infants and children. Healthcare claims and other administrative databases can be used to monitor uptake of medical services [33,34]. Use of these types of data are advantageous since the information is computerized and are available for large patient populations.…”

Section: Discussionmentioning

confidence: 99%

Laboratory testing for cytomegalovirus among pregnant women in the United States: a retrospective study using administrative claims data

et al. 2012

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BackgroundRoutine cytomegalovirus (CMV) screening during pregnancy is not recommended in the United States and the extent to which it is performed is unknown. Using a medical claims database, we computed rates of CMV-specific testing among pregnant women.MethodsWe used medical claims from the 2009 Truven Health MarketScan® Commercial databases. We computed CMV-specific testing rates using CPT codes.ResultsWe identified 77,773 pregnant women, of whom 1,668 (2%) had a claim for CMV-specific testing. CMV-specific testing was significantly associated with older age, Northeast or urban residence, and a diagnostic code for mononucleosis. We identified 44 women with a diagnostic code for mononucleosis, of whom 14% had CMV-specific testing.ConclusionsFew pregnant women had CMV-specific testing, suggesting that screening for CMV infection during pregnancy is not commonly performed. In the absence of national surveillance for CMV infections during pregnancy, healthcare claims are a potential source for monitoring practices of CMV-specific testing.

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Section: Discussionmentioning

confidence: 99%

Laboratory testing for cytomegalovirus among pregnant women in the United States: a retrospective study using administrative claims data

et al. 2012

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“…Following methods described in previous studies, 14,15 we identified delivery discharges by using ICD-9-CM 16 and diagnosis-related group (DRG) 17 codes. Starting with 2007 data, NIS reported codes from DRG version 24 (DRG24), which could handle a maximum of 579 diagnoses, and Medicare Severity DRGs (MS-DRGs), which increased the number of DRGs by 207 (in effect since October 1, 2007).…”

Section: Identification Of Delivery Hospitalizations and Hiv Diagnosesmentioning

confidence: 99%

“…Delivery discharge DRG codes 14,15 • Cesarean section: 370-371 (DRG24 codes 2006-2007); 765-766 (MS-DRG codes 2008-2014) • Vaginal delivery: 372-375 (DRG24 codes 2006-2007); 767-768, 774-775 (MS-DRG codes 2008-2014) ICD-9-CM codes 14,15 • Outcomes of delivery: V27.x • Normal delivery: 650…”

Section: Item Definitionmentioning

confidence: 99%

Trends in Women With an HIV Diagnosis at Delivery Hospitalization in the United States, 2006-2014

et al. 2020

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Objectives The risk of mother-to-child HIV transmission can be reduced to ≤0.5% if the mother’s HIV status is known before delivery. This study describes 2006-2014 trends in diagnosed HIV infection documented on delivery discharge records and associated sociodemographic characteristics among women who gave birth in US hospitals. Methods We analyzed data from the 2006-2014 National Inpatient Sample and identified delivery discharges and women with diagnosed HIV infection by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We used a generalized linear model with log link and binomial distribution to assess trends and the association of sociodemographic characteristics with an HIV diagnosis on delivery discharge records. Results During 2006-2014, an HIV diagnosis was documented on approximately 3900-4400 delivery discharge records annually. The probability of having an HIV diagnosis on delivery discharge records decreased 3% per year (adjusted relative risk [aRR] = 0.97; 95% CI, 0.94-0.99), with significant declines identified among white women aged 25-34 (aRR = 0.93; 95% CI, 0.88-0.97) or those using Medicaid (aRR = 0.93; 95% CI, 0.90-0.97); among black women aged 25-34 (aRR = 0.95; 95% CI, 0.92-0.99); and among privately insured women who were black (aRR = 0.96; 95% CI, 0.92-0.99), Hispanic (aRR = 0.92; 95% CI, 0.86-0.98), or aged 25-34 (aRR = 0.96; 95% CI, 0.92-0.99). The probability of having an HIV diagnosis on delivery discharge records was greater for women who were black (aRR = 8.45; 95% CI, 7.56-9.44) or Hispanic (aRR = 1.56; 95% CI, 1.33-1.83) than white; for women aged 25-34 (aRR = 2.33; 95% CI, 2.12-2.55) or aged ≥35 (aRR = 3.04; 95% CI, 2.79-3.31) than for women aged 13-24; and for Medicaid recipients (aRR = 2.70; 95% CI, 2.45-2.98) or the uninsured (aRR = 1.87; 95% CI, 1.60-2.19) than for privately insured patients. Conclusion During 2006-2014, the probability of having an HIV diagnosis declined among select sociodemographic groups of women delivering neonates. High-impact prevention efforts tailored to women remaining at higher risk for HIV infection can reduce the risk of mother-to-child HIV transmission.

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“…Studies have also shown that healthcare providers’ adherence to testing guidelines varies significantly from one infectious disease to the other, and that maternal factors such as insurance type and geographical location are factors that contribute to low adherence [ 8 , 9 ]. Several studies have also noted significant differences in providers’ adherence level based on data source [ 8 , 10 – 14 ]. The use of administrative data such as Medicaid data has shown providers’ adherence to prenatal syphilis testing to be 60% [ 13 ] while studies utilizing clinical records have found higher adherence rate over 80% [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

Ojo

Arno

Tao

et al. 2021

BMC Pregnancy Childbirth

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Background The number of congenital syphilis (CS) cases in the United States are increasing. Effective prevention of CS requires routine serologic testing and treatment of infected pregnant women. The Centers for Disease Control and Prevention (CDC) recommends testing all pregnant women at their first prenatal visit and subsequent testing at 28 weeks gestation and delivery for women at increased risk. Methods We conducted a cross-sectional cohort study of syphilis testing among pregnant women with a livebirth delivery from January 2014 to December 2016 in Marion County, Indiana. We extracted and linked maternal and infant data from the vital records in a local health department to electronic health records available in a regional health information exchange. We examined syphilis testing rates and factors associated with non-testing among women with livebirth delivery. We further examined these rates and factors among women who reside in syphilis prevalent areas. Results Among 21260 pregnancies that resulted in livebirths, syphilis testing in any trimester, including delivery, increased from 71.7% in 2014 to 86.6% in 2016. The number of maternal syphilis tests administered only at delivery decreased from 16.6% in 2014 to 4.04% in 2016. Among women living in areas with high syphilis rates, syphilis screening rates increased from 79.6% in 2014 to 94.2% in 2016. Conclusion Improvement in prenatal syphilis screening is apparent and encouraging, yet roughly 1-in-10 women do not receive syphilis screening during pregnancy. Adherence to recommendations set out by CDC improved over time. Given increasing congenital syphilis cases, the need for timely diagnoses and prevention of transmission from mother to fetus remains a priority for public health.

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Estimating prenatal syphilis and HIV screening rates for commercially insured women

Cited by 16 publications

References 12 publications

Laboratory testing for cytomegalovirus among pregnant women in the United States: a retrospective study using administrative claims data

Laboratory testing for cytomegalovirus among pregnant women in the United States: a retrospective study using administrative claims data

Trends in Women With an HIV Diagnosis at Delivery Hospitalization in the United States, 2006-2014

Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

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