scholarly journals STD Testing and Compliance with CDC and USPSTF HIV Testing Guidelines in a Regional Cohort of Emergency Departments

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Fredric M. Hustey ◽  
Michael P. Phelan ◽  
Sharon O'keefe ◽  
Tracy M. Barbour

In 2003, the CDC estimated that 1 million people in the USA were living with HIV/AIDS, and  25% were undiagnosed. For many such patients the ED may be the only contact with the health care system. This study assessed compliance with CDC and USPTF guidelines for HIV testing in patients seeking evaluation for STDs in a regional cohort of emergency departments. 13927 patients patients underwent screening for STDs during the study period. Only 397 (2.85%) also received HIV screening while 107 (0.8%) received both HIV and syphyllis screening as per federal recommendations.

Author(s):  
Fredric M. Hustey ◽  
Michael P. Phelan ◽  
Sharon O'keefe ◽  
Tracy M. Barbour

In 2003, the CDC estimated that 1 million people in the USA were living with HIV/AIDS, and 25% were undiagnosed. For many such patients the ED may be the only contact with the health care system. We surveyed ED staff to evaluate attitudes and barriers towards ED based HIV testing. We found that in spite of recent CDC recommendations for HIV testing in high risk ED patients, there are still significant barriers to acceptance among ED health care providers.


2020 ◽  
Vol 26 (4) ◽  
pp. 108-115
Author(s):  
А.B. Zimenkovsky ◽  
◽  
T.G. Gutor ◽  

Aim - the search, analysis and systematization of historical facts concerning the formation and evo-lution of the world medical standartization; severance of its certain long-standing models for the optimization of settling and introduction of the existing, and future analogs, particularly, in the clinical audit format. Material and Methods. In order to study the medical standard as a historical component the fol-lowing methods were used: bibliographic, historical, analytical and methods of systematization and comparison. Results and Discussion. As a result of the conducted research the main historical events in the world development of the medical standartization starting from 1500 up till nowadays were col-lected. In order to study the evolution of the medical standartization, the analysis of the normative documents that have regulated the process of standartization, especially the Doctor's statute(s) in Russia, Minimal standard of the medical equipment and works of the American college of surgeons, was carried out. The scientific works that initiated the introduction of the clinical audit in the Health Care system in Ukraine, Turkey, the USA and Great Britain were throroughly analyzed. Conclusions. The improvement of quality as to rendering the medical aid is a job priority in the health care systems in many countries. For that reason, the search for its optimization was and is still retrieved for many centuries. The territorial formation of medical standartization is associated with England, Russia and the USA, but the occurrence of clinical audit is connected with Ukraine, Turkey, the USA and Great Britain. The foundations of the medical standardization was lauched in 1500 year, while the clinical audit - in 1854 year. The medical standartization is a reflection of the history of development of the organization of health care system, that's why the expertness (knowl-edge) of historical stages concerning the setting and the introduction of medical standartization may give a new impulse in its improvement and development under present-day conditions of reforma-tion in the medical sphere in Ukraine. The earlier beginning of implementation of the medical stan-dartization in the health care system in different countries makes it possible to actualize its introduc-tion into the clinical audit format, that, in its turn, allows to improve the quality of rendering the medical aid. Key words: medical standartization, clinical audit, quality of medical aid


2009 ◽  
Vol 20 (8) ◽  
pp. 527-533 ◽  
Author(s):  
V Sundaram ◽  
L C Lazzeroni ◽  
L R Douglass ◽  
G D Sanders ◽  
P Tempio ◽  
...  

Despite recommendations for voluntary HIV screening, few medical centres have implemented screening programmes. The objective of the study was to determine whether an intervention with computer-based reminders and feedback would increase screening for HIV in a Department of Veterans Affairs (VA) health-care system. The design of the study was a randomized controlled trial at five primary care clinics at the VA Palo Alto Health Care System. All primary care providers were eligible to participate in the study. The study intervention was computer-based reminders to either assess HIV risk behaviours or to offer HIV testing; feedback on adherence to reminders was provided. The main outcome measure was the difference in HIV testing rates between intervention and control group providers. The control group providers tested 1.0% ( n = 67) and 1.4% ( n = 106) of patients in the preintervention and intervention period, respectively; intervention providers tested 1.8% ( n = 98) and 1.9% ( n = 114), respectively ( P = 0.75). In our random sample of 753 untested patients, 204 (27%) had documented risk behaviours. Providers were more likely to adhere to reminders to test rather than with reminders to perform risk assessment (11% versus 5%, P < 0.01). Sixty-one percent of providers felt that lack of time prevented risk assessment. In conclusion, in primary care clinics in our setting, HIV testing rates were low. Providers were unaware of the high rates of risky behaviour in their patient population and perceived important barriers to testing. Low-intensity clinical reminders and feedback did not increase rates of screening.


The Lancet ◽  
2017 ◽  
Vol 389 (10077) ◽  
pp. 1431-1441 ◽  
Author(s):  
Samuel L Dickman ◽  
David U Himmelstein ◽  
Steffie Woolhandler

2011 ◽  
Vol 19 (5) ◽  
pp. 433-443
Author(s):  
Clemens Rissbacher ◽  
Christof Rissbacher ◽  
Sabine Röhlich ◽  
Dagmar Meraner

2013 ◽  
Vol 40 (4) ◽  
pp. 341-345 ◽  
Author(s):  
Henry D. Anaya ◽  
Jaimi N. Butler ◽  
Jeffrey L. Solomon ◽  
Herschel Knapp ◽  
Tuyen Hoang ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254476
Author(s):  
Muhammad Ahmed Abdullah ◽  
Babar Tasneem Shaikh ◽  
Haider Ghazanfar

Background Pakistan’s National AIDS Control Program has registered 44,000 HIV/AIDS patients to date, but the actual number of cases have been estimated to be as high as 150,000–170,000. The health care system has a very important role to play in this equation and must be reformed to improve the health care services in Pakistan, with regards to HIV/AIDS. Methods It was a qualitative research employing a phenomenological approach. The principal researcher visited nine public and private health care facilities and conducted 19 key informant interviews with people working for providing preventive and curative services, in addition to the observations made on the site. Results Pakistan’s health system has a limited capacity to address the HIV spread in the country, with its current resources. There is an obvious scarcity of resources at the preventive, diagnostic and curative level. However, menace can be curtailed through measures taken at the service delivery level by checking the unsafe needles practices, unclean surgical procedures and an unregulated and untrained private health workforce which are dangerous potentials routes of transmission of the virus to the general population. Healthcare establishments carry the chances of nosocomial infections including HIV/AIDS. Poverty, illiteracy and stigma associated with the disease is compounding the overall situation. Conclusion Improved accessibility to service delivery with a greater focus on prevention would be imperative to address the threat of HIV/AIDS in Pakistan. A health systems approach would help in identifying gaps at both strategic and operational levels, and concurrently find and implement solutions.


2001 ◽  
Vol 16 (1-2) ◽  
pp. 203-222 ◽  
Author(s):  
David A. Cherin ◽  
G. J. Huba ◽  
Lisa A. Melchior ◽  
Susan Enguidanos ◽  
W. June Simmons ◽  
...  

2011 ◽  
Vol 3 (1) ◽  
pp. 97-114
Author(s):  
Robert B. Matthews ◽  
G. Keith Jenkins ◽  
Joey Robertson

The passage of the Affordable Care Act (“ACA” or “Obamacare”) in 2010 promises to bring about significant changes in the way that health care is provided and paid for in the United States of America (USA). Supporters of ACA point to a 2000 WHO study of worldwide health care systems in which the USA ranked 37th as justification for proposed changes, and many of them have expressed a preference for ultimately implementing a single-payer or single-provider system (such as currently exists in Canada or the United Kingdom). Detractors, who generally label the act Obamacare, have expressed concerns about whether the act can achieve its stated objectives, whether it represents a negative step instead of a positive one, and whether the ultimate goal of a single-payer or single-provider system is desirable one or even an achievable one. In the context of the ongoing debate over health care in the USA, this paper reviews the WHO study and subsequent comparative analyses of world health care systems to address the following questions:Does the USA really have the 37th best health care system in the world?Does either a “single-payer” health care system or a “single-provider” health care system offer prospects for significant improvement?What model or models for delivery of health care services represent “best practices” and how can and should they be emulated? 


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