Document Detail


Evaluation of a testing-only "express" visit option to enhance efficiency in a busy STI clinic.
MedLine Citation:
PMID:  18277943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the use of a testing-only "express" visit option to enhance efficiency in a busy STI clinic. METHODS: At the Denver Metro Health Clinic, clients at low risk for sexually transmitted infections (STI) are offered an express visit comprised of a urine test for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) as well as optional syphilis and human immunodeficiency virus (HIV) testing, but no physical examination. Higher risk clients (STI-related symptoms, contact to STI, men having sex with men, injection drug use, exchange of sex for money or drugs) are offered a comprehensive visit that includes a physical examination. The triage system was evaluated for the period April 2005--July 2006 by comparing rates of CT, GC, syphilis, and HIV between the 2 visit options. RESULTS: Of 13,447 clients with new visits, 3284 (24.4%) were express visits. When compared with clients with comprehensive visits, express visit clients had lower rates of CT (8.1% vs. 17.2%), GC (0.9% vs. 7.4%), syphilis (0.7% vs. 1.2%), and HIV (0.1% vs. 0.2%). Of 2969 STI cases, only 10.8% were diagnosed among clients with express visits. Express visits resulted in a 39% time saving for men and a 56% for women. With the possible exception of asymptomatic urethritis among men, underdiagnosis of STI beyond CT, GC, syphilis, and HIV among express visit clients appeared to be low. CONCLUSION: The triage system at DMHC effectively selects clients at highest risk for STI and increases clinic efficiency.
Authors:
Sara J Shamos; Christie J Mettenbrink; Julie A Subiadur; Brandy L Mitchell; Cornelis A Rietmeijer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Sexually transmitted diseases     Volume:  35     ISSN:  0148-5717     ISO Abbreviation:  Sex Transm Dis     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-25     Completed Date:  2008-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7705941     Medline TA:  Sex Transm Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-40     Citation Subset:  IM    
Affiliation:
Denver Public Health Department, Denver, Colorado 80204-4506, USA.
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MeSH Terms
Descriptor/Qualifier:
AIDS Serodiagnosis
Adult
Ambulatory Care Facilities / statistics & numerical data,  utilization*
Chlamydia Infections* / diagnosis,  drug therapy,  epidemiology
Chlamydia trachomatis / isolation & purification
Female
Gonorrhea* / diagnosis,  drug therapy,  epidemiology
HIV Infections / diagnosis,  drug therapy,  epidemiology
Humans
Male
Neisseria gonorrhoeae / isolation & purification
Nucleic Acid Amplification Techniques / methods*
Office Visits / statistics & numerical data,  utilization*
Prevalence
Sexually Transmitted Diseases / drug therapy,  epidemiology,  etiology,  prevention & control*
Syphilis / diagnosis,  drug therapy,  epidemiology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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