我国两城市公立医疗机构性病医疗服务调查

Investigation on Medical Service of STD in Pulbic Medical Department of Two Cities in China

目的 评价我国城市公立医疗机构性病服务质量水平 ,为改善其服务提出建议。方法 选择我国两城市的所有性病专科门诊和部分综合医院皮肤科、泌尿科和性病科作为被调查机构 ,直接观察医生处理男性尿道分泌物和男女生殖器溃疡病例的过程。结果 共观察 46名医生处理 93例男性尿道分泌物和男女生殖器溃疡病例。按照WHO/GPA方案计算得到预防指标 6 (PI - 6 )为 2 9%(完整的病史采集为 77%、充分体检为 6 9%、有效治疗为 5 5 %) ,预防指标 7(PI- 7)为 3%(性伴通知为 5 3%、建议使用避孕套为 3%)。结论 我国公立医疗机构的性病服务存在着重视临床、忽视预防的问题 ,应加强医务人员的培训以改善性病服务质量。

Objective In order to evaluate the quality of STD case managemet in public sector of two cities in China as baseline for intervention,all STD clinics and part departments of dermatology,urology and andrology in two cities were enrolled for evaluation.The evaluatin was based on direct observation of health care providers managing urethral discharge,genital ulcer disease in men and genital ulcer disease in women.Results Forty-six health care providers were observed managing 93 patients presenting with selected STD syndromes(urethral discharge in men,genital ulcer disease in men and genital ulcer disease in women).STD case management was assessed by calculation of WHO/GPA prevention indicators(PIs)from observation data.The overall rate for PI-6,which measures correct assessment and treatment of STD patients was 29%(77% for history taking,69% in physical examination,and 55% for effective treatment).The score for PI-7,which measures overall patient counselling was 3%(53% for partner notification and 3% for condom promotion).The data showed that the quality of STD case management in public sector was not satisfactory,especially preventive service.Training of health care providers was necessary to improve STD case management.