From the New York State Department of Health, AIDS Institute, Bureau of Sexual Health and Epidemiology.
Department of Health Policy, Management and Behavior of Epidemiology, State University of New York at Albany, Albany, NY.
Sex Transm Dis. 2020 Nov;47(11):733-738. doi: 10.1097/OLQ.0000000000001241.
From November 2014 to May 2016, 57 local health departments in New York State (NYS) excluding New York City were offered a performance incentive (PI) to promote adherence to federally recommended treatment guidelines for gonorrhea. The rationale of the PI was to delay antibiotic resistance and disrupt transmission through attaining a high percentage of treatment adherence.
Surveillance data from the NYS Communicable Disease Electronic Surveillance System were used for analysis. We evaluated adherence per Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines for persons 12 years and older reported with uncomplicated gonorrhea during 4 time frames: Pre-PI, PI One, PI Two, and Post-PI. We measured adherence per the Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines during each respective time frame and conducted χ tests to test for the association between treatment adequacy and time frame.
During the Pre-PI, treatment was adequate in 82.0% of persons diagnosed with gonorrhea. After program implementation, treatment adequacy increased significantly (92.1% of diagnosed persons during PI One, 90.4% during PI Two, and 90.5% during the Post-PI; P ≤ 0.0001). The most common reason for inadequate or missing treatment was patient lost to follow-up.
Public health intervention by the NYS Department of Health improved local health department adherence to federally recommended gonorrhea treatment guidelines, and improvements were maintained after the completion of the PI.
从 2014 年 11 月到 2016 年 5 月，纽约州（不包括纽约市）的 57 个地方卫生部门获得了一项绩效激励（PI），以促进遵循联邦推荐的淋病治疗指南。PI 的基本原理是通过达到高比例的治疗依从率来延迟抗生素耐药性并阻断传播。
使用来自纽约州传染病电子监测系统的监测数据进行分析。我们根据疾病控制和预防中心的性传播疾病治疗指南评估了每个时间框架内的依从性：PI 之前、PI 一、PI 二和 PI 之后。我们根据疾病控制和预防中心的性传播疾病治疗指南测量了每个相应时间框架内的治疗依从性，并进行了 χ 检验以检验治疗充分性与时间框架之间的关联。
在 PI 之前，82.0%被诊断患有淋病的人接受了充分的治疗。方案实施后，治疗充分性显著增加（PI 一时，82.1%的诊断患者；PI 二时，90.4%；PI 后时，90.5%；P ≤ 0.0001）。治疗不充分或缺失的最常见原因是患者失访。
纽约州卫生部的公共卫生干预措施提高了地方卫生部门对联邦推荐的淋病治疗指南的依从性，并且在 PI 完成后仍保持了改进。
