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纽约州医疗机构中性传播感染的管理:谁在关注性传播感染护理的质量?

Management of sexually transmitted infections in New York State health care organizations: who is thinking about the quality of STI care?

作者信息

Janowski John Patrick B, Garrett William S, Feller Daniel J, Hathaway Rebecca, Kushner John, Pelish Matthew, Agins Bruce D

机构信息

From the *Office of the Medical Director, New York State Department of Health (NYSDOH) AIDS Institute, New York, NY; †Office of Health Emergency Preparedness, NYSDOH, Menands, NY; and ‡NYSDOH, Bureau of Healthcom Network Systems Management, Menands, NY.

出版信息

Sex Transm Dis. 2014 Sep;41(9):519-24. doi: 10.1097/OLQ.0000000000000171.

Abstract

BACKGROUND

Rising rates of sexually transmitted infections (STIs) warrant a renewed focus on the management of STIs in health care organizations. The extent to which hospitals and community health centers (CHCs) have established processes and allocated staff for the management of STIs within their organizations remains poorly understood.

METHODS

A New York State Department of Health survey was distributed electronically through a closed state communication network to targeted administrators at New York State hospitals and CHCs. The survey asked if STI management in their facilities included the following: the ability to measure and report rates of STIs, a process to assess the quality of STI care and treatment outcomes, and a centralized person/unit to coordinate its work throughout the facility. Multivariate analysis was performed to identify whether organizational characteristics were associated with survey findings.

RESULTS

Ninety-five percent (243/256) of hospitals and CHCs responded to the survey. Fifty percent of respondents had a person or unit to report rates of STIs; 30% reported an organization-wide process for monitoring the quality of STI care, which, according to the multivariate analysis, was associated with CHCs; only 23% reported having a centralized person or unit for coordinating STI management.

CONCLUSIONS

Most facilities report STI cases to comply with public health surveillance requirements but do not measure infection rates, assess the quality of STI care, or coordinate its work throughout the facility. The development of this organizational capacity would likely decrease STI rates, improve treatment outcomes, and address local public health goals.

摘要

背景

性传播感染(STIs)发病率的上升使得医疗保健机构需要重新关注性传播感染的管理。医院和社区卫生中心(CHCs)在其组织内建立性传播感染管理流程并分配工作人员的程度仍知之甚少。

方法

纽约州卫生部的一项调查通过封闭的州通信网络以电子方式分发给纽约州医院和社区卫生中心的目标管理人员。该调查询问其设施中的性传播感染管理是否包括以下内容:测量和报告性传播感染发病率的能力、评估性传播感染护理质量和治疗结果的流程,以及在整个设施内协调其工作的集中人员/单位。进行多变量分析以确定组织特征是否与调查结果相关。

结果

95%(243/256)的医院和社区卫生中心回复了调查。50%的受访者有人员或单位报告性传播感染发病率;30%报告有全组织范围的性传播感染护理质量监测流程,根据多变量分析,这与社区卫生中心有关;只有23%报告有集中的人员或单位协调性传播感染管理。

结论

大多数机构报告性传播感染病例是为了符合公共卫生监测要求,但不测量感染率、评估性传播感染护理质量或在整个设施内协调其工作。这种组织能力的发展可能会降低性传播感染发病率、改善治疗结果并实现当地公共卫生目标。

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