Emergency department testing patterns for sexually transmitted diseases in North Texas

Arti Barnes, Katelyn K. Jetelina, Andrea C. Betts, Theresa Mendoza, Pranavi Sreeramoju, Jasmin A. Tiro

Research output: Contribution to journalArticle

Abstract

Background Little is known about population-level sexually transmitted disease (STD) testing in emergency departments (EDs). We sought to explore STD testing patterns in EDs in a large, urban metroplex in North Texas, a high prevalence region. Methods Emergency department claims data were extracted from the Dallas Fort Worth Hospital Council databank for patients attending 54 EDs in 4 counties (Dallas, Tarrant, Collin, and Denton) who were tested for an STD during an ED visit between July 2014 and June 2015. We analyzed patterns of testing for 3 types of STD tests: (1) combined gonorrhea and chlamydia DNA-based tests, (2) human immunodeficiency virus (HIV) antibody tests, and (3) syphilis serological tests. Results Emergency departments administered at least 1 STD test to 65,702 unique patients over 1 year; most were ethnoracial minorities (73%), female (72%), and had no known insurance (59%). Only 8% of patients received more than 1 of these tests at that same visit; of those, 90% were cotested for HIV. The most common diagnosis code associated with STD testing was "genital/urinary symptoms" (31%). The majority of tests took place at the ED of a single county-funded hospital (42%). Only 36% of all patients had visits that were deemed true emergencies. Conclusions Most patients tested for syphilis, HIV, or chlamydia/gonorrhea in EDs received only 1 test type at that visit, and most visits were nonemergent in nature. Given shared risk factors for multiple STD and high coinfection rates, EDs serving high-risk populations could consider STD cotesting to help reduce transmission of undiagnosed, untreated infections.

Original languageEnglish (US)
Pages (from-to)434-439
Number of pages6
JournalSexually Transmitted Diseases
Volume46
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Sexually Transmitted Diseases
Hospital Emergency Service
Chlamydia
Gonorrhea
Syphilis
HIV
County Hospitals
HIV-2
Serologic Tests
Insurance
Coinfection
Population
Emergencies
Databases
Antibodies
DNA
Infection

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Emergency department testing patterns for sexually transmitted diseases in North Texas. / Barnes, Arti; Jetelina, Katelyn K.; Betts, Andrea C.; Mendoza, Theresa; Sreeramoju, Pranavi; Tiro, Jasmin A.

In: Sexually Transmitted Diseases, Vol. 46, No. 7, 01.07.2019, p. 434-439.

Research output: Contribution to journalArticle

Barnes, Arti ; Jetelina, Katelyn K. ; Betts, Andrea C. ; Mendoza, Theresa ; Sreeramoju, Pranavi ; Tiro, Jasmin A. / Emergency department testing patterns for sexually transmitted diseases in North Texas. In: Sexually Transmitted Diseases. 2019 ; Vol. 46, No. 7. pp. 434-439.
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abstract = "Background Little is known about population-level sexually transmitted disease (STD) testing in emergency departments (EDs). We sought to explore STD testing patterns in EDs in a large, urban metroplex in North Texas, a high prevalence region. Methods Emergency department claims data were extracted from the Dallas Fort Worth Hospital Council databank for patients attending 54 EDs in 4 counties (Dallas, Tarrant, Collin, and Denton) who were tested for an STD during an ED visit between July 2014 and June 2015. We analyzed patterns of testing for 3 types of STD tests: (1) combined gonorrhea and chlamydia DNA-based tests, (2) human immunodeficiency virus (HIV) antibody tests, and (3) syphilis serological tests. Results Emergency departments administered at least 1 STD test to 65,702 unique patients over 1 year; most were ethnoracial minorities (73{\%}), female (72{\%}), and had no known insurance (59{\%}). Only 8{\%} of patients received more than 1 of these tests at that same visit; of those, 90{\%} were cotested for HIV. The most common diagnosis code associated with STD testing was {"}genital/urinary symptoms{"} (31{\%}). The majority of tests took place at the ED of a single county-funded hospital (42{\%}). Only 36{\%} of all patients had visits that were deemed true emergencies. Conclusions Most patients tested for syphilis, HIV, or chlamydia/gonorrhea in EDs received only 1 test type at that visit, and most visits were nonemergent in nature. Given shared risk factors for multiple STD and high coinfection rates, EDs serving high-risk populations could consider STD cotesting to help reduce transmission of undiagnosed, untreated infections.",
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AB - Background Little is known about population-level sexually transmitted disease (STD) testing in emergency departments (EDs). We sought to explore STD testing patterns in EDs in a large, urban metroplex in North Texas, a high prevalence region. Methods Emergency department claims data were extracted from the Dallas Fort Worth Hospital Council databank for patients attending 54 EDs in 4 counties (Dallas, Tarrant, Collin, and Denton) who were tested for an STD during an ED visit between July 2014 and June 2015. We analyzed patterns of testing for 3 types of STD tests: (1) combined gonorrhea and chlamydia DNA-based tests, (2) human immunodeficiency virus (HIV) antibody tests, and (3) syphilis serological tests. Results Emergency departments administered at least 1 STD test to 65,702 unique patients over 1 year; most were ethnoracial minorities (73%), female (72%), and had no known insurance (59%). Only 8% of patients received more than 1 of these tests at that same visit; of those, 90% were cotested for HIV. The most common diagnosis code associated with STD testing was "genital/urinary symptoms" (31%). The majority of tests took place at the ED of a single county-funded hospital (42%). Only 36% of all patients had visits that were deemed true emergencies. Conclusions Most patients tested for syphilis, HIV, or chlamydia/gonorrhea in EDs received only 1 test type at that visit, and most visits were nonemergent in nature. Given shared risk factors for multiple STD and high coinfection rates, EDs serving high-risk populations could consider STD cotesting to help reduce transmission of undiagnosed, untreated infections.

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