From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Sex Transm Dis. 2014 Jan;41(1):67-73. doi: 10.1097/OLQ.0000000000000058.
To describe recent trends in the receipt of sexually transmitted disease (STD) services among women (age, 15-44 years) from 2002 to 2006-2010 using the National Survey of Family Growth.
We analyzed trends in demographics, health insurance, and visit-related variables of women reporting receipt of STD services (counseling, testing, or treatment) in the past 12 months. We also analyzed trends in the source of STD services and the payment method used.
Receipt of STD services reported by women in the past 12 months increased from 2002 (12.6%) to 2006-2010 (16.0%; P < 0.001). Receipt of services did not increase among adolescents (P = 0.592). Among women receiving STD services from a private doctor/HMO, the percentage with private insurance decreased over time (74.6%-66.8%), whereas the percentage with Medicaid increased (12.8%-19.7%; P = 0.020). For women receiving STD services at a public clinic or nonprimary care facility, there were no statistically significant differences by demographics, except that fewer adolescents but more young adults reported using a public clinic over time (P = 0.038). Among women who reported using Medicaid as payment, receipt of STD services at a public clinic significantly decreased (36.8%-25.4%; P = 0.019). For women who paid for STD services with private insurance, the only significant difference was an increase in having a copay over time (61.3%-70.1%; P = 0.012).
Despite a significant increase in receipt of STD services over time, many women at risk for STDs did not receive services including adolescents. In addition, we identified important shifts in payment methods during this time frame.
利用国家家庭成长调查,描述 2002 年至 2006-2010 年期间,15-44 岁女性获得性传播疾病(STD)服务的最新趋势。
我们分析了在过去 12 个月内报告获得 STD 服务(咨询、检测或治疗)的女性的人口统计学、健康保险和就诊相关变量的趋势。我们还分析了 STD 服务来源和使用的支付方式的趋势。
在过去 12 个月内,报告获得 STD 服务的女性比例从 2002 年(12.6%)增加到 2006-2010 年(16.0%;P<0.001)。青少年的服务获得率没有增加(P=0.592)。在从私人医生/HMO 获得 STD 服务的女性中,私人保险的比例随着时间的推移而下降(74.6%-66.8%),而医疗补助的比例上升(12.8%-19.7%;P=0.020)。在从公共诊所或非初级保健机构获得 STD 服务的女性中,除了随着时间的推移,报告使用公共诊所的青少年人数减少但年轻成年人人数增加外(P=0.038),人口统计学特征方面没有统计学显著差异。在报告使用医疗补助作为支付方式的女性中,在公共诊所获得 STD 服务的比例显著下降(36.8%-25.4%;P=0.019)。对于用私人保险支付 STD 服务费用的女性,唯一的显著差异是随着时间的推移,共付额增加(61.3%-70.1%;P=0.012)。
尽管 STD 服务的获得率随着时间的推移有了显著的提高,但仍有许多感染 STD 风险的女性,包括青少年,并未获得服务。此外,我们在这段时间内发现了支付方式的重要转变。