Martin Erika G, Feng Wenhui, Qian Feng, Johnson Britney
Nelson A. Rockefeller Institute of Government-State University of New York, Albany, New York (Dr Martin); Rockefeller College of Public Affairs & Policy (Dr Martin and Mss Feng and Johnson) and School of Public Health (Dr Qian), University at Albany-State University of New York, Albany, New York; and New York State Department of Health, Albany, New York (Ms Johnson).
J Public Health Manag Pract. 2017 May/Jun;23(3):242-246. doi: 10.1097/PHH.0000000000000351.
Partner services for HIV and sexually transmitted diseases, a public health intervention activity recommended by the Centers for Disease Control and Prevention, includes counseling, partner notification, linkage to care, and referral to other services.
A time study of partner services case investigations documented differences in times to process HIV/sexually transmitted disease cases.
Cases were from 9 local and regional sites in New York.
Fifty-two partner services disease investigators documented 542 randomly selected cases (271 chlamydial infections, 162 gonorrhea, 48 HIV, and 61 syphilis cases) assigned between June and September 2014. Cases were the unit of the analysis and represented 6.9% of all partner services investigations in 2014.
Cases were selected via stratified random sampling of infections assigned to staff. For each case, disease investigators completed a standard time study form to document the time spent on specific tasks and other outcomes. Kruskal-Wallis tests for continuous variables and χ tests for categorical variables assessed variation in outcomes across infection type.
Outcomes included minutes spent on specific tasks (such as medical provider and index case outreach, travel, and partner notification), days the case remained open, disposition codes, and number of partners reached.
Case processing times varied, with HIV and syphilis tasks taking more minutes (P < .001) and cases staying open for more days (P < .001). Partners were notified in 33% of cases overall, with more notifications in syphilis (44%). Most time (median = 77%) was spent on index cases and 2% (median) on partner notification, with a wide range across cases.
Given their chronic resource constraints, public health agencies must identify efficient methods to allocate resources, including which infections to prioritize. Documenting how workers allocate time across cases is essential to improving the effectiveness and efficiency of this program and generating the data to model return on investment.
为艾滋病毒和性传播疾病提供伙伴服务是美国疾病控制与预防中心推荐的一项公共卫生干预活动，包括咨询、性伴通知、与医疗服务的衔接以及转介至其他服务。
一项关于伙伴服务病例调查的时间研究记录了处理艾滋病毒/性传播疾病病例的时间差异。
病例来自纽约的9个地方和区域场所。
52名伙伴服务疾病调查员记录了2014年6月至9月期间随机抽取的542例病例（271例衣原体感染、162例淋病、48例艾滋病毒感染和61例梅毒病例）。病例是分析单位，占2014年所有伙伴服务调查的6.9%。
通过对分配给工作人员的感染病例进行分层随机抽样来选择病例。对于每个病例，疾病调查员填写一份标准时间研究表格，记录在特定任务上花费的时间和其他结果。对连续变量进行Kruskal-Wallis检验，对分类变量进行χ检验，以评估不同感染类型的结果差异。
结局包括在特定任务上花费的分钟数（如与医疗服务提供者和索引病例联系、出行以及性伴通知）、病例持续开放的天数、处置代码以及联系到的性伴数量。
病例处理时间各不相同，艾滋病毒和梅毒任务花费的分钟数更多（P < 0.001），病例开放的天数也更多（P < 0.001）。总体上33%的病例通知了性伴，梅毒病例的通知率更高（44%）。大部分时间（中位数 = 77%）花在索引病例上，2%（中位数）花在性伴通知上，不同病例差异很大。
鉴于公共卫生机构长期面临资源限制，必须确定有效的资源分配方法，包括确定哪些感染应优先处理。记录工作人员如何在不同病例间分配时间对于提高该项目的有效性和效率以及生成投资回报率模型的数据至关重要。
