RESUMO
We reviewed charts of newly diagnosed STD patients in three health facilities to determine the proportion who received follow-up STD screening. In a 12-month period, the three facilities had 140 STD cases. STD screening was not indicated for 50 (36%) patients. Among the 90 remaining STD patients, 29 (32%) were screened and 61 (68%) not screened. Among non-screened patients, 36% (22/61) were tested, but outside the time parameters allowed by the audit. The remaining 64% (39/61) received no screening at all, and represented clinical missed opportunities; in this group, nearly all (95%) had chlamydia but were not screened for HIV or syphilis. Linking chlamydia patients with a screen for HIV and syphilis using a clinical reminder in the facilities' electronic health record (EHR) or other tool, would eliminate 95% of the missed opportunities in this sample.
Assuntos
Pesquisa sobre Serviços de Saúde , Programas de Rastreamento/métodos , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Feminino , Humanos , Masculino , Resultado do Tratamento , Estados Unidos , United States Indian Health ServiceRESUMO
Propelled by a staggering burden of national and provincial debt, Canada has been overtaken by reform of its health system. New Brunswick's regionalization of hospital services has been a fascinating experience in health care reform, and many of its characteristics have now been emulated by other provinces. The approach has been bold, challenging and exciting.
