Evaluating the Quality of Sexual Health Care Provided to Adolescents in Medicaid Managed Care: A Comparison of Two Data Sources

American Journal of Medical Quality

Volumn 19, Issue 1, 2004, Pages 2-11

  Downey, Lois ^a   Lafferty, William E ^a   Tao, Guoyu ^b   Irwin, Kathleen L ^c  

^a UNIVERSITY OF WASHINGTON   (United States)

^b CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

^c CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

Author keywords

Administrative data; Adolescent sexual health care; Data quality; Data sources; Health care quality evaluation methods; Medicaid managed care; Medical record review

Indexed keywords

ADOLESCENT; ADULT; CHLAMYDIA; CONTROLLED STUDY; COST BENEFIT ANALYSIS; DATA ANALYSIS; EVALUATION; FEMALE; HEALTH CARE COST; HEALTH CARE QUALITY; HEALTH CENTER; HUMAN; LOGISTIC REGRESSION ANALYSIS; MAJOR CLINICAL STUDY; MALE; MANAGED CARE; MANAGED CARE ORGANIZATION; MEDICAID; MEDICAL RECORD; QUALITATIVE ANALYSIS; RELIABILITY; REVIEW; SEXUAL BEHAVIOR;

EID: 0742269949     PISSN: 10628606     EISSN: None     Source Type: Journal    
DOI: 10.1177/106286060401900102     Document Type: Review

References (33)

1. Casalino L, Gillies RR, Shortell SM, et al. External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. J Am Med Assoc. 2003;289:434-441.
2. Kaiser Family Foundation. Sexually transmitted diseases in America: how many cases and at what cost? Prepared by American Social Health Association, December 1998. Available at: http://www.kff.org/content/archive/1445/std_rep. htm. Accessed February 9, 2001.
3. Cates W. Estimates of the incidence and prevalence of sexually transmitted diseases in the United States: American Social Health Association Panel. Sex Transm Dis. 1999;26(suppl 4):S2-S7.
4. Eng TR, Butler WT, eds. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: National Academy Press; 1997.
5. Elster AB, Kuznets NJ, eds. AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale. Baltimore, Md: Williams & Wilkins; 1994.
6. US Preventive Services Task Force. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. 2nd ed. Washington, DC: Office of Disease Prevention and Health Promotion, US Government Printing Office; 1996.
7. Centers for Disease Control and Prevention. 1998 Guidelines for treatment of sexually transmitted diseases. MMWR. 1998;47(RR-1):1-127.
8. National Committee for Quality Assurance. HEDIS 2000: The Health Plan Employer Data and Information Set. Volume 1: Narrative - What's in It and Why It Matters. Washington, DC: National Committee for Quality Assurance; 2000.
9. Centers for Disease Control and Prevention. Youth risk behavior surveillance - United States, 2001. MMWR. 2002;51(SS04):1-64.
10. Kaiser Family Foundation. What teens know and don't (but should) about sexually transmitted diseases: a national survey finds few sexually experienced 15-17 year olds get tested for STDs, and most underestimate their risk. Available at: http://www.kff.org/content/archive/1465/stds_t.pdf. Accessed March 30, 2003.
11. Bolan G, Ehrhardt AA, Wasserheit JN. Gender perspectives and STDs. In: Holmes KK, Mardh P-A, Sparling PF, et al, eds. Sexually Transmitted Diseases. 3rd ed. New York: McGraw-Hill; 1999:117-127.
12. Centers for Disease Control and Prevention, Division of Sexually Transmitted Disease Prevention. Sexually Transmitted Disease Surveillance - 1999. Atlanta, Ga: Centers for Disease Control and Prevention; 2000.
13. Mangione-Smith R, McGlynn EA, Hiatt L. Screening for chlamydia in adolescents and young women. Arch Pediatr Adolesc Med. 2000;154:1108-1113.
14. US Census Bureau. Poverty 2001. Available at: http://www.census.gov/hhes/ www/poverty01.html. Accessed April 4, 2003.
15. Holtgrave DR, Crosby RA. Social capital, poverty, and income inequality as predictors of gonorrhoea, syphilis, chlamydia and AIDS case rates in the United States. Sex Transm Infect. 2003;79:62-64.
16. US Centers for Medicare and Medicaid Services. Managed care as a percentage of total Medicaid, 1991-1995. Available at: http://cms.hhs.gov/ medicaid/managedcare/pctoftot.pdf. Accessed March 30, 2003.
17. US Centers for Medicare and Medicaid Services. 2002 Medicaid managed care enrollment report: penetration rates from 1996-2002 - national summary table, managed care trends. Available at: http://cms.hhs.gov/medicaid/ managedcare/trends02.pdf. Accessed March 30, 2003.
18. Kaiser Family Foundation. Medicaid managed care: an overview. Available at: http://www.kff.org/content/archive/2102/budget_rep1.html. Accessed April 11, 2003.
19. Cotter JJ, Smith WR, Rossiter LF, et al. Combining state administrative databases and provider records to assess the quality of care for children enrolled in Medicaid. Am J Med Qual. 1999;14:98-104.
20. MacDonald E. Better coding through improved documentation: strategies for the current environment. J AHIMA 1999;70:32-35.
21. Noller JR. Coders join forces with physicians to improve clinical outcomes. J AHIMA. 2000;71:43-49.
22. Romano PS, Roos LL, Luft HS, et al. A comparison of administrative versus clinical data: coronary artery bypass surgery as an example. J Clin Epidemiol. 1994;47:249-260.
23. Garnick DW, Hendricks AM, Comstock CB. Measuring quality of care: fundamental information from administrative datasets. Int J Qual Health Care. 1994;6:163-177.
24. American Medical Association. Current Procedural Terminology: CPT. Chicago, Ill: American Medical Association; 1998.
25. Health Care Financing Administration. ICD-9-CM: International Classification of Diseases, 9th Revision, Clinical Modification. 4th ed. Los Angeles, Calif: Practice Management Information Corporation; 1994.
26. Health Care Financing Administration. HCFA Common Procedure Coding System (HCPCS). Washington, DC: Health Care Financing Administration; 1985.
27. Thrall JS, McCloskey L, Spivak SL, et al. Performance of Massachusetts HMOs in providing Pap smear and sexually transmitted disease screening to adolescent females. J Adolesc Health. 1998;22:184-189.
28. Rainey DY, Brandon CP, Krowchuk DP. Confidential billing accounts for adolescents in private practice. J Adolesc Health. 2000;26:389-391.
29. Fowles JB, Lawthers AG, Weiner JP, et al. Agreement between physicians' office records and Medicare Part B claims data. Health Care Financ Rev. 1995;16:189-199.
30. Centers for Medicare and Medicaid Services. A guide for states to assist in the collection and analysis of Medicaid managed care data. 2nd ed. Available at: http://cms.hhs.gov/medicaid/managedcare/enguide.asp. Accessed March 30, 2003.
31. Centers for Medicare and Medicaid Services. Validating encounter data: a protocol for use in conducting Medicaid external quality review activities. Available at: http://www.cms.hhs.gov/medicaid/managedcare/protoencd.pdf. Accessed April 1, 2003.
32. Fleiss JL. Statistical Methods for Rates and Proportions. 2nd ed. New York: John Wiley & Sons; 1981.
33. Tao G, Anderson LA, Irwin KL. Understanding sexual activity defined in the HEDIS measure of screening young women for Chlamydia trachomatis. Jt Comm J Qual Improv. 2002;28:435-440.