Prenatal syphilis screening rates: Are they being accurately reported?

Prenatal syphilis screening, recommended by the Centers for Disease Control, medical professional organizations, and public health authorities, is critical to preventing still births and serious birth defects in babies of affected mothers.

A study published in the April issue of the journal Sexually Transmitted Diseases reports that state Medicaid statistics, when used to determine screening rates, may seriously underestimate the number of expectant mothers being screened for syphilis.

Researchers led by Marc Rosenman, M.D., of the Indiana University School of Medicine and the Regenstrief Institute compared four years of Medicaid data from the state of Indiana with data from the Regenstrief Medical Record System (RMRS) for women seen in Wishard Health Services. Of the nearly 4,000 women with both Medicaid and RMRS data, only half had evidence of prenatal syphilis screening recorded in Medicaid claims data, while more than 99 percent had at least one laboratory report of syphilis screening recorded in the RMRS, indicating that Medicaid numbers were missing nearly half the women screened.

“What our study points out is that analyses based on Medicaid data might not tell the whole story. And this problem is not unique to Indiana. Our findings add perspective to a CDC-funded study of Florida Medicaid data which reported a prenatal syphilis screening rate of about 50 percent, a rate very similar to what we found in Indiana Medicaid data,” said Dr. Rosenman, an assistant professor of pediatrics at the IU School of Medicine and a research scientist at the Regenstrief Institute.

Why are Medicaid data incomplete? Reasons may vary from how the test is billed to how data are transmitted from a physician’s office, clinic or hospital to a state agency.

“Prenatal syphilis screening is a vital step in preventing serious illness. The nearly universal prenatal screening we report is not necessarily typical of other health systems across the state and nation, for a variety of reasons including that this study was conducted at a large public teaching hospital and began during a major syphilis outbreak in Indianapolis in 1998-1999, and since then physicians, health systems, and the county health department have probably all been extra conscientious in encouraging screening. But what is clear is that Medicaid data by far underestimate how much screening is taking place,” said Dr. Rosenman. “The same is probably true of other published estimates based on commercial insurance data.”

Syphilis, a sexually transmitted disease, is on the increase in the United States. A simple blood test is used to screen for the disease. An at-risk woman should be screened for syphilis multiple times during her pregnancy including immediately prior to delivery.

Source: Indiana University

Related stories:

Perceived access to cigarettes predicts youth smoking
Kids who see cigarettes as easily accessible are more likely to end up as regular smokers, particularly if they have friends who smoke, according to a new report published in the current issue of Annals of Family Medicine. The study, funded by the Substance Abuse Policy Research Program (SAPRP) of the Robert Wood Johnson Foundation, could be valuable to smoking intervention efforts by allowing health professionals to identify and target high-risk children.
Study shows high rates, rising costs of alcohol/drug disorders in hospitalized patients
Alcohol abuse more common in insured patients, drug abuse in uninsured
Fourteen percent of patients admitted to the hospital have alcohol/drug abuse and addiction (ADAA) disorders, costs for which have risen sharply in recent years, according to a study in the June issue of the Journal of Substance Abuse Treatment (JSAT).
In early childhood, continuous care by 1 doctor improves delivery of health screenings
Children examined by the same doctor during their first six months of life are more likely to receive appropriate preventive health screenings -- for lead poisoning, anemia and tuberculosis -- by age two. Pediatric researchers said being cared for repeatedly by the same physician, often referred to as continuity of care, was a very important factor in the children they studied.
US cancer deaths down but far too few Americans screened for colon cancer
New data revealing decreasing trends in cancer deaths in the United States overall, and in colorectal cancer deaths in particular, highlight the remarkable benefits of colorectal cancer screening tests, but the lifesaving potential of these tests is unrealized for many Americans according to experts from the American College of Gastroenterology. Racial minorities, uninsured Americans and even Medicare patients who should be tested are not being screening appropriately, and other recent studies reveal that they are diagnosed with more advanced cancers compared to patients with private insurance.
Major study links insurance status to advanced stage in multiple cancers
A new American Cancer Society study of twelve types of cancer among more than 3.5 million cancer patients finds uninsured patients were significantly more likely to present with advanced stage cancer compared to patients with private insurance. The study, which appears in the March issue of The Lancet Oncology, is the first to use national data to investigate insurance status and stage of diagnosis for a large number of cancer sites. It finds the strongest association between insurance status and advanced cancer was for cancers that can be detected early by screening or evaluation of symptoms.
IDSA: 2009 Bush budget a disaster for HIV/AIDS
The President’s proposed budget for fiscal year 2009, if enacted, would spell disaster for the nation’s health, and by extension, our national effort to respond to the HIV/AIDS epidemic in the United States.
Studies link insurance coverage to more advanced cancers
Two new studies find the uninsured and people with certain types of public health insurance are more likely to be diagnosed with more advanced cancer compared to those with private insurance. The studies, published in the July 15, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, find availability and type of health insurance predict disease severity in patients presenting with cancer of the oral cavity and breast in the United States.
Low health insurance caps leave patients stranded
(AP) -- Mary Wusterbarth thought her toddler was struggling with an ear infection when she seemed sluggish. Instead, a virus had attacked the little girl's heart, damaging it beyond repair. Brea needed a transplant.

News discussion:

Medicine & Health news