Open AccessMeasuring the Uptake and Impact of Chlamydia Screening Programs—Easier Said Than Done
Author(s) -
Joan M. Chow
Publication year - 2012
Publication title -
sexually transmitted diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.507
H-Index - 105
eISSN - 1537-4521
pISSN - 0148-5717
DOI - 10.1097/olq.0b013e318245f95c
Subject(s) - medicine , chlamydia , accountability , legislation , population , public health , pelvic inflammatory disease , patient protection and affordable care act , health care , tubal factor infertility , family medicine , reproductive health , environmental health , gynecology , nursing , medicaid , infertility , economic growth , pregnancy , political science , biology , economics , law , immunology , genetics
The passage of the landmark United States (U.S.) Patient Protection and Affordable Care Act (ACA) of 2010 has placed a new emphasis on prevention services, including increased access, coverage, and improved quality of care. In this legislation, chlamydia screening qualifies along with other preventive services (The Patient Protection and Affordable Care Act, P.H. 111-148, March 2010, §2,713) as an essential health service benefit by virtue of having an "A" rating ("strongly recommended") from the U.S. Preventive Services Task Force. However, along with this important commitment of public health resources comes accountability by demonstrating outcomes and results. It should not come as a surprise that in the current era of unprecedented government budget reductions, there is a compelling need for evidence-based prioritization and impact assessment. Funding agencies increasingly need health program data to show the impact of investment in preventive services, and chlamydia screening is no exception. However, measuring the population-level impact of chlamydia screening expansion in the U.S. since the 1980s has been problematic; conflicting data on screening uptake, chlamydia burden, and adverse reproductive outcomes, including pelvic inflammatory disease (PID) and tubal factor infertility, have all been challenging to interpret, despite compelling epidemiologic evidence supporting intervention.