Abstract

Effective management for sexually transmitted diseases (STDs) depends on appropriate testing, treatment, partner management, and complete and timely reporting of positive STD tests (1). Testing can ensure appropriate treatment of initial or recurrent infections and identification of drug-resistant pathogens, appropriate treatment can reduce risk for complications and development of drug resistance, and complete and timely reporting of positive test results by laboratories and STD cases by health-care providers to health departments can facilitate rapid sex partner notification and outbreak detection. By 1998, private providers, including those affiliated with commercial or Medicaid managed care organizations (MCOs) (2,3) were caring for approximately 70% of persons with chlamydia and 55% of persons with gonorrhea. To assess the quality of STD care at a MCO-affiliated multisite facility, the testing, treatment, and reporting practices of gonorrhea- and chlamydia-associated urethritis in male patients were evaluated. This report summarizes the evaluation, which indicated that the providers tested most men with urethritis symptoms, prescribed CDC-recommended therapy to all patients, and reported most laboratory-confirmed chlamydia and gonorrhea cases of urethritis to the state health department. Several interventions introduced at this large group practice may have encouraged these favorable STD practices.

Highlights

  • This report summarizes the evaluation, which indicated that the providers tested most men with urethritis symptoms, prescribed CDC-recom410 mended therapy to all patients, and reported most laboratory-confirmed chlamydia and gonorrhea cases of urethritis to the state health department

  • To evaluate completeness and timeliness of reporting to Massachusetts Department of Public Health (MDPH), a database was compiled of 393 cases of laboratory-confirmed gonorrhea and chlamydia infections diagnosed in men during 1995-1997

  • This database included 31 symptomatic urethritis cases with positive chlamydia or gonorrhea tests that were included in the medical record review

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Summary

Affiliated With a Managed Care

EFFECTIVE MANAGEMENT FOR SEXUALLY transmitted diseases (STDs) depends on appropriate testing, treatment, partner management, and complete and timely reporting of positive STD tests. Testing can ensure appropriate treatment of initial or recurrent infections and identification of drug-resistant pathogens, appropriate treatment can reduce risk for complications and development of drug resistance, and complete and timely reporting of positive test results by laboratories and STD cases by health-care providers to health departments can facilitate rapid sex partner notification and outbreak detection. To assess the quality of STD care at a MCO-affiliated multisite facility, the testing, treatment, and reporting practices of gonorrhea- and chlamydiaassociated urethritis in male patients were evaluated. This report summarizes the evaluation, which indicated that the providers tested most men with urethritis symptoms, prescribed CDC-recom410 mended therapy to all patients, and reported most laboratory-confirmed chlamydia and gonorrhea cases of urethritis to the state health department. To evaluate completeness and timeliness of reporting to MDPH, a database was compiled of 393 cases of laboratory-confirmed gonorrhea and chlamydia infections diagnosed in men during 1995-1997. This database included 31 symptomatic urethritis cases with positive chlamydia or gonorrhea tests that were included in the medical record review. Reported by: S Ratelle, MD, Y Tang, MD, M Whelan, MA, P Etkind, DrPH, Massachusetts Dept of Public

FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION
Findings
Among Persons
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