How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs?

Objectives: To quantify the contribution of patient delay, provider delay, and diversion between services to delayed access to genitourinary medicine (GUM) clinics. To describe the factors associated with delay, and their contribution to STI transmission. Methods: Cross-sectional survey of 3184 cons...

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Veröffentlicht in:Sexually transmitted infections 2007-08, Vol.83 (5), p.400-405
Hauptverfasser: Mercer, Catherine H, Sutcliffe, Lorna, Johnson, Anne M, White, Peter J, Brook, Gary, Ross, Jonathan D C, Dhar, Jyoti, Horner, Paddy, Keane, Frances, Jungmann, Eva, Sweeney, John, Kinghorn, George, Garnett, Geoff G, Stephenson, Judith M, Cassell, Jackie A
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container_end_page 405
container_issue 5
container_start_page 400
container_title Sexually transmitted infections
container_volume 83
creator Mercer, Catherine H
Sutcliffe, Lorna
Johnson, Anne M
White, Peter J
Brook, Gary
Ross, Jonathan D C
Dhar, Jyoti
Horner, Paddy
Keane, Frances
Jungmann, Eva
Sweeney, John
Kinghorn, George
Garnett, Geoff G
Stephenson, Judith M
Cassell, Jackie A
description Objectives: To quantify the contribution of patient delay, provider delay, and diversion between services to delayed access to genitourinary medicine (GUM) clinics. To describe the factors associated with delay, and their contribution to STI transmission. Methods: Cross-sectional survey of 3184 consecutive new patients attending four GUM clinics purposively selected from across England to represent different types of population. Patients completed a short written questionnaire that collected data on sociodemographics, access, and health-seeking behaviour. Questionnaires were then linked to routinely collected individual-level demographic and diagnostic data. Results: Patient delay is a median of 7 days, and does not vary by demographic or social characteristics, or by clinic. However, attendance at a walk-in appointment was associated with a marked reduction in patient delay and provider delay. Among symptomatics, 44.8% of men and 58.0% of women continued to have sex while awaiting treatment, with 7.0% reporting sex with >1 partner; 4.2% of symptomatic patients reported sex without using condoms with new partner(s) since their symptoms had begun. Approximately 25% of all patients had already sought or received care in general practice, and these patients experienced greater provider delay. Conclusions: Walk-in services are associated with a reduction in patient and provider delay, and should be available to all populations. Patients attending primary care require clear care pathways when referred on to GUM clinics. Health promotion should encourage symptomatic patients to seek care quickly, and to avoid sexual contact before treatment.
doi_str_mv 10.1136/sti.2006.024554
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To describe the factors associated with delay, and their contribution to STI transmission. Methods: Cross-sectional survey of 3184 consecutive new patients attending four GUM clinics purposively selected from across England to represent different types of population. Patients completed a short written questionnaire that collected data on sociodemographics, access, and health-seeking behaviour. Questionnaires were then linked to routinely collected individual-level demographic and diagnostic data. Results: Patient delay is a median of 7 days, and does not vary by demographic or social characteristics, or by clinic. However, attendance at a walk-in appointment was associated with a marked reduction in patient delay and provider delay. Among symptomatics, 44.8% of men and 58.0% of women continued to have sex while awaiting treatment, with 7.0% reporting sex with &gt;1 partner; 4.2% of symptomatic patients reported sex without using condoms with new partner(s) since their symptoms had begun. Approximately 25% of all patients had already sought or received care in general practice, and these patients experienced greater provider delay. Conclusions: Walk-in services are associated with a reduction in patient and provider delay, and should be available to all populations. Patients attending primary care require clear care pathways when referred on to GUM clinics. Health promotion should encourage symptomatic patients to seek care quickly, and to avoid sexual contact before treatment.</description><identifier>ISSN: 1368-4973</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sti.2006.024554</identifier><identifier>PMID: 17475683</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Ambulatory Care ; Behaviour ; Biological and medical sciences ; Clinics ; Cross-Sectional Studies ; Delivery of Health Care ; England ; Epidemiology. Vaccinations ; Family Practice - statistics &amp; numerical data ; Female ; General aspects ; Gonorrhea ; Health services ; Human infectious diseases. Experimental studies and models ; Humans ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Patient Acceptance of Health Care - statistics &amp; numerical data ; Patients ; Primary care ; Questionnaires ; Regression analysis ; Risk Factors ; Sexual health ; Sexually transmitted diseases ; Sexually Transmitted Diseases - transmission ; STD ; Women</subject><ispartof>Sexually transmitted infections, 2007-08, Vol.83 (5), p.400-405</ispartof><rights>Copyright 2007 Sexually Transmitted Infections</rights><rights>2007 INIST-CNRS</rights><rights>Copyright: 2007 Copyright 2007 Sexually Transmitted Infections</rights><rights>Copyright ©2007 BMJ Publishing Group.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b522t-f5d385bab93af3ce9513afcb3650c9e0c0f9512ade6251b01ec2e468c6a6119b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://sti.bmj.com/content/83/5/400.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://sti.bmj.com/content/83/5/400.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,727,780,784,885,3196,23571,27924,27925,53791,53793,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=18941353$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17475683$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mercer, Catherine H</creatorcontrib><creatorcontrib>Sutcliffe, Lorna</creatorcontrib><creatorcontrib>Johnson, Anne M</creatorcontrib><creatorcontrib>White, Peter J</creatorcontrib><creatorcontrib>Brook, Gary</creatorcontrib><creatorcontrib>Ross, Jonathan D C</creatorcontrib><creatorcontrib>Dhar, Jyoti</creatorcontrib><creatorcontrib>Horner, Paddy</creatorcontrib><creatorcontrib>Keane, Frances</creatorcontrib><creatorcontrib>Jungmann, Eva</creatorcontrib><creatorcontrib>Sweeney, John</creatorcontrib><creatorcontrib>Kinghorn, George</creatorcontrib><creatorcontrib>Garnett, Geoff G</creatorcontrib><creatorcontrib>Stephenson, Judith M</creatorcontrib><creatorcontrib>Cassell, Jackie A</creatorcontrib><title>How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs?</title><title>Sexually transmitted infections</title><addtitle>Sex Transm Infect</addtitle><description>Objectives: To quantify the contribution of patient delay, provider delay, and diversion between services to delayed access to genitourinary medicine (GUM) clinics. To describe the factors associated with delay, and their contribution to STI transmission. Methods: Cross-sectional survey of 3184 consecutive new patients attending four GUM clinics purposively selected from across England to represent different types of population. Patients completed a short written questionnaire that collected data on sociodemographics, access, and health-seeking behaviour. Questionnaires were then linked to routinely collected individual-level demographic and diagnostic data. Results: Patient delay is a median of 7 days, and does not vary by demographic or social characteristics, or by clinic. However, attendance at a walk-in appointment was associated with a marked reduction in patient delay and provider delay. Among symptomatics, 44.8% of men and 58.0% of women continued to have sex while awaiting treatment, with 7.0% reporting sex with &gt;1 partner; 4.2% of symptomatic patients reported sex without using condoms with new partner(s) since their symptoms had begun. Approximately 25% of all patients had already sought or received care in general practice, and these patients experienced greater provider delay. Conclusions: Walk-in services are associated with a reduction in patient and provider delay, and should be available to all populations. Patients attending primary care require clear care pathways when referred on to GUM clinics. 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Among symptomatics, 44.8% of men and 58.0% of women continued to have sex while awaiting treatment, with 7.0% reporting sex with &gt;1 partner; 4.2% of symptomatic patients reported sex without using condoms with new partner(s) since their symptoms had begun. Approximately 25% of all patients had already sought or received care in general practice, and these patients experienced greater provider delay. Conclusions: Walk-in services are associated with a reduction in patient and provider delay, and should be available to all populations. Patients attending primary care require clear care pathways when referred on to GUM clinics. Health promotion should encourage symptomatic patients to seek care quickly, and to avoid sexual contact before treatment.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>17475683</pmid><doi>10.1136/sti.2006.024554</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aged
Ambulatory Care
Behaviour
Biological and medical sciences
Clinics
Cross-Sectional Studies
Delivery of Health Care
England
Epidemiology. Vaccinations
Family Practice - statistics & numerical data
Female
General aspects
Gonorrhea
Health services
Human infectious diseases. Experimental studies and models
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Patients
Primary care
Questionnaires
Regression analysis
Risk Factors
Sexual health
Sexually transmitted diseases
Sexually Transmitted Diseases - transmission
STD
Women
title How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs?
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