Privatization of STD Services in Tacoma, Washington: A Quality Review


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Abstract

Background and Objectives:This study describes key features of the privatized model of sexually transmitted disease (STD) service provision in Tacoma, Washington.Goals:To assess the operational characteristics and the quality of care provided in the privatized STD clinics.Study Design:Key informant interviews and surveys were conducted. Medical records were reviewed and compared to a standardized STD clinic medical record. Client treatment was compared to the Centers for Disease Control and Prevention (CDC) 1993 STD Treatment Guidelines.Results:In 1997, the contract clinics provided 3,275 publicly sponsored STD visits. The goals of multiple access sites, STD screening, appropriate therapy for laboratory-diagnosed, bacterial STD were achieved. However, medical records were frequently incomplete and Gram stains were not done. Significant deviations from CDC STD Treatment Guidelines were documented in the medical management of pelvic inflammatory disease (PID).Conclusions:Privatized STD services would be improved by use of a standardized medical record. Availability of a Gram stain and management of PID as recommended by the CDC would augment quality of care.

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