Reporting of gonorrhea by private physicians: a behavioral study

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Gonorrhea underreporting by physicians is a significant public health challenge.
• Hypotheses for underreporting include lack of saliency, patient interference, and administrative burden.

Purpose of the Study:

• To test interventions for improving gonorrhea case reporting among physicians.
• To evaluate the effectiveness of a telephone-based reporting system.

Main Methods:

• Physicians in the Denver Metropolitan Area were randomized into study groups.
• A periodic telephone contact intervention was implemented by Health Department clerical personnel.
• Case reporting rates were compared between intervention and control groups.

Main Results:

• The telephone reporting system more than doubled the number of reported gonorrhea cases.
• The intervention showed the most significant impact on physicians who had not previously reported cases and those practicing alone.
• An estimated 42% of cases were reported, exceeding rates from retrospective surveys.

Conclusions:

• A simple, clerical-staff-initiated telephone reporting system is an effective and inexpensive tool for enhancing gonorrhea surveillance.
• This intervention can substantially improve the accuracy of gonorrhea morbidity estimates.
• The impact of undernotification on public health can be locally assessed using such systems.