Does place of service matter? A utilisation and cost analysis of sexually transmissible infection testing from 2012 claims data

Abstract

Background In this study, a previous study on the utilisation and cost of sexually transmissible infection (STI) tests was augmented by focusing on outpatient place of service for the most utilised tests.

Methods: Claims for eight STI tests [chlamydia, gonorrhoea, hepatitis B virus (HBV), HIV, human papillomavirus (HPV), herpes simplex virus type 2 (HSV2), syphilis and trichomoniasis] using the most utilised current procedural terminology (CPT) code for each STI from the 2012 MarketScan outpatient table were extracted. The volume and costs by gender and place of service were then summarised. Finally, semi-log regression analyses were used to further examine and compare costs.

Results: Females had a higher number of test claims than males in all places of service for each STI. Together, claims from 'Independent Laboratories', 'Office' and 'Outpatient hospital' accounted for over 93% of all the test claims. The cost of tests were slightly (<5%) different between males and females for most places of service. Except for the estimated average cost for 'Outpatient hospital', the estimated average costs for the other categories were significantly lower (15-80%, P<0.01) than the estimated average cost for 'Emergency Room - Hospital' for all the STIs. Among the predominant service venues, test costs from 'Independent Laboratory' and 'Office' were 30% to 69% lower (P<0.01) than those from 'Outpatient Hospital'.

Conclusions: Even though the results from this study are not generalisable, our study shows that almost all STI tests from outpatient claims data were performed in three service venues with considerable cost variations.

Fig. 1.

Frequency and distribution of claims for the most commonly used non-viral sexually transmissible infection tests by place of service, 2012. CT, Chlamydia trachomatis; NG, Neisseria gonorrhoeae (gonorrhoea); TP, Treponema pallidum (syphilis); TV, Trichomonas vaginalis (trichomoniasis).

Fig. 2.

Frequency and distribution of claims for the most commonly used viral sexually transmissible infection tests by place of service, 2012. HBV, hepatitis B virus; HPV, human papillomavirus; HSV2, herpes simplex virus 2.

Fig. 3.

Average cost of the commonly used non-viral sexually transmissible infection tests by place of service, 2012. CT, Chlamydia trachomatis; NG, Neisseria gonorrhoeae (gonorrhoea); TP, Treponema pallidum (syphilis); TV, Trichomonas vaginalis (trichomoniasis).

Fig. 4.

Average cost of the most commonly used viral sexually transmissible infection tests by place of service, 2012. HBV, hepatitis B virus; HPV, human papillomavirus; HSV2, herpes simplex virus 2.