Keane F E, Young S M
Department of Genito-urinary Medicine, Leicester Royal Infirmary, UK.
Int J STD AIDS. 1994 Sep-Oct;5(5):318-21; discussion 322-6. doi: 10.1177/095646249400500503.
We sought to ascertain general practitioners' (GPs) views on their patients' attendances at genitourinary medicine (GUM) departments regarding methods of referral, record keeping and supplying of information to insurance companies. A questionnaire was sent to 429 local GPs of whom 294 (68%) responded. A written means of referral was less likely for HIV than for sexually transmitted disease (STD) (P < 0.001), and in turn less likely for STD than for other genital problems (P < 0.02). The percentage of GPs who did not keep a record of referrals were: For HIV testing--29%; STDs--13%; and for other genital problems--8%. Whilst 48% of GPs did not feel obliged to divulge lifestyle information on a patient, 21% would feel it necessary to confirm that a patient had suffered from an STD if the 'source' on a cytology smear was shown to be that of a GUM department. Only 23 GPs (8%) felt they had sufficient knowledge as to the use to which the information they supplied to insurance companies was put. Many GPs acknowledged that their practice, with reference to patient attendance at a GUM department, was influenced by life insurance considerations. Bearing in mind the current policy of The Association of British Insurers which recommends that all applicants for life insurance be asked to declare any previous STD and counselling/testing for HIV, we make several suggestions which may aid GPs in this difficult area.
我们试图确定全科医生（GPs）对于其患者前往泌尿生殖医学（GUM）科室就诊在转诊方法、记录保存以及向保险公司提供信息方面的看法。向429名当地全科医生发送了问卷，其中294人（68%）做出了回应。与性传播疾病（STD）相比，HIV的书面转诊方式可能性更低（P < 0.001），而反过来，STD的书面转诊方式可能性又低于其他生殖器问题（P < 0.02）。未保留转诊记录的全科医生比例分别为：HIV检测——29%；性传播疾病——13%；其他生殖器问题——8%。虽然48%的全科医生认为没有义务透露患者的生活方式信息，但如果细胞学涂片的“来源”显示为泌尿生殖医学科室，21%的医生会觉得有必要确认患者曾患过性传播疾病。只有23名全科医生（8%）觉得他们对所提供给保险公司的信息用途有足够了解。许多全科医生承认，他们关于患者前往泌尿生殖医学科室就诊的做法受到人寿保险考虑因素的影响。鉴于英国保险协会目前的政策建议所有人寿保险申请人都要申报既往任何性传播疾病以及接受过的HIV咨询/检测，我们提出了一些建议，可能有助于全科医生在这个困难领域开展工作。
