GUM & primary care based STI services: Maximising STI control & cost-effectiveness for a population.

我们的目标是建立一个基于网络的工具，帮助公共卫生决策者根据当地人口的特点规划最有效的性传播感染服务。性传播感染患者参加各种服务，包括专科泌尿生殖医学（GUM）诊所和初级保健（包括全科医生手术）。2001年，政府公布了“性健康和艾滋病毒国家战略”。它建议今后应在初级保健中提供更多的性传播感染服务。从那时起，许多地区开始增加全科医生和执业护士对性传播感染的检测和治疗。这些服务通常被称为“地方增强服务”，差异很大，决策者和服务专员发现很难制定适当的地方计划。所有性传播感染服务的目的是尽可能经济有效地减少性传播感染的传播。许多因素影响到在地方卫生经济中实现这一目标的程度，例如，服务的能力、被诊断为性传播感染的人的伴侣也得到治疗的程度、服务机构是否为感染性传播感染风险较高或较低的人提供服务。这些很难衡量。我们将开发工具来衡量现有服务的公共卫生成果，并使用建模技术来确定服务提供的关键要素，这些要素可能影响初级保健和牙龈提供的不同组合的有效性（即预防性传播感染的数量）和成本效益。由此产生的网络工具将促进在英国各地为性传播感染提供基于证据的服务规划。

We aim to build a web-based tool to help public health decision-makers plan the most effective services for sexually transmitted infections (STIs) according to the characteristics of their local population. Patients with STIs attend a variety of services, including specialist genitourinary medicine (GUM) clinics and primary care (including GP surgeries). In 2001, the government published the ‘National Strategy for Sexual Health and HIV‘. It proposed that, in future, more services for STIs should be provided in primary care. Since then, many areas have started to increase testing for, and treatment, of STIs by GPs and practice nurses. These services, usually called ‘Locally Enhanced Services’, vary considerably, and decision-makers and service commissioners have found it difficult to make appropriate local plans. The aim of all STI services is to reduce the transmission of STIs as cost-effectively as possible. A number of factors influence how well this is achieved in local health economies e.g. the capacity of the services, the extent that the partners of people diagnosed with STIs are also treated, whether services are seeing people at greater or lower risk of STIs. These can be hard to measure. We will develop instruments to measure public health outcomes of existing services and use modelling techniques to identify the key elements of service provision that could impact on the effectiveness (i.e. the number of STIs prevented) and the cost effectiveness of different combinations of primary care and GUM provision. The resulting web tool will facilitate local evidence-based planning of services for STIs across the UK.