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Sexually transmitted diseases and managed care: an inquiry and
review of issues affecting service delivery.
American Journal of Medical Quality 2004;19(4):145-156.
Chorba T, Scholes D, BlueSpruce J, Operskalski BH, Irwin K.
Abstract
To understand the potential role of managed care organizations (MCOs) in prevention
and control of sexually transmitted diseases (STDs), we conducted a systematic
review of articles on STDs and managed care and sought qualitative information
from MCOs on STD-related activities. The review focused on prevention, risk
assessment, patient education, counseling, screening, and costs of care,
but revealed relatively few published articles. Barriers to STD service delivery
included competing priorities, lack of time or supporting organizational
structures, and differing mandates of health departments and MCOs. Facilitators
included collaboration between health departments and MCOs, regulatory and
performance incentives, buy-in from key stakeholders, availability of infrastructure
to support data collection, and inclusion of chlamydia screening in the Health
Employer Data and Information Set to monitor plan performance. Because of
the shift of STD service delivery from the public to private sector, incentives
need to maximize interest and cooperation of patients, clinicians, and MCOs
in STD prevention.