Existence, Distribution, and Characteristics of STD Clinics in the United States, 2017.
Existence, Distribution, and Characteristics of STD Clinics in the United States, 2017.
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2017 年美国性病诊所的存在、分布和特征。
DOI：
10.1177/0033354919847733
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Stoner,BradleyP
中科院分区：
文献类型：
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作者：
Meyerson,BethE;Davis,Alissa;Reno,Hilary;Haderxhanaj,LauraT;Sayegh,MAaron;Simmons,MeganK;Multani,Gurprit;Naeyaert,Lindsey;Meador,Audra;Stoner,BradleyP
目的性传播疾病(STD)诊所的研究一直受到缺乏代表性抽样的全国性名单的限制。我们试图确定STD诊所的数量、类型和分布，并描述与它们相关的选定社区特征。方法我们从2014年9月到2015年3月和2017年5月到10月进行了两个阶段的多层次在线搜索，以确定美国所有50个州和哥伦比亚特区的STD诊所。我们获得了诊所名称、地址、联系信息和340B资金状况的数据(这要求制造商以较低的价格提供门诊药物)。我们按类型对诊所进行了分类。我们还获得了二级县级数据，以比较衣原体和艾滋病毒、青少年出生、未参保和失业以及高中毕业率；初级保健医生与人口的比率；医疗保健成本；家庭收入中位数；以及生活在农村地区和非农村地区的人口比例。结果共发现性病门诊4079家，将其分为10类，2530家(62.0%)隶属于当地卫生部门。在3129个县中，有1098个县(35.1%)没有性病门诊。12个州在每个县都有性病诊所，34个州每10万≥人口有1个 诊所。大多数性病诊所位于衣原体发病率较高和其他替代需求最大的地区；农村地区的性病诊所服务不足。结论本清单有助于更全面地研究性病诊所对外部政策变化(如公共融资或患者准入政策)的适应情况，以及长期诊所生存情况，并特别关注农村地区的诊所覆盖范围。
ObjectivesStudies of sexually transmitted disease (STD) clinics have been limited by the lack of a national list for representative sampling. We sought to establish the number, type, and distribution of STD clinics and describe selected community characteristics associated with them.MethodsWe conducted a 2-phased, multilevel, online search from September 2014 through March 2015 and from May through October 2017 to identify STD clinics in all 50 US states and the District of Columbia. We obtained data on clinic name, address, contact information, and 340B funding status (which requires manufacturers to provide outpatient drugs at reduced prices). We classified clinics by type. We also obtained secondary county-level data to compare rates of chlamydia and HIV, teen births, uninsurance and unemployment, and high school graduation; ratios of primary care physician to population; health care costs; median household income; and percentage of population living in rural areas vs nonrural areas. We usedttests to examine mean differences in characteristics between counties with and without STD clinics.ResultsWe found 4079 STD clinics and classified them into 10 types; 2530 (62.0%) clinics were affiliated with a local health department. Of 3129 counties, 1098 (35.1%) did not have an STD clinic. Twelve states had an STD clinic in every county, and 34 states had ≥1 clinic per 100 000 population. Most STD clinics were located in areas of high chlamydia morbidity and where other surrogate needs were greatest; rural areas were underserved by STD clinics.ConclusionsThis list may aid in more comprehensive national studies of clinic services, STD clinic adaptation to external policy changes (eg, in public financing or patient access policy), and long-term clinic survival, with special attention to clinic coverage in rural areas.