title: Sexually transmitted diseases and managed care: an inquiry and review of issues affecting service delivery.
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.
authors.affiliation: Health Services and Evaluation Branch, Division of STD Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. tlc2@cdc.gov
authors.forename: Terence
authors.initials: T
authors.lastname: Chorba
authors.forename: Delia
authors.initials: D
authors.lastname: Scholes
authors.forename: June
authors.initials: J
authors.lastname: Bluespruce
authors.forename: Belinda H
authors.initials: BH
authors.lastname: Operskalski
authors.forename: Kathleen
authors.initials: K
authors.lastname: Irwin
mesh_terms: D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D003376:Counseling; D003625:Data Collection; D003695:Delivery of Health Care / Q000458:organization & administration*; D017048:Health Care Costs; D006292:Health Priorities; D006302:Health Services Research; D006801:Humans; D007373:Interinstitutional Relations; D008329:Managed Care Programs / Q000458:organization & administration*; D008403:Mass Screening; D020380:Needs Assessment; D009656:North America; D015279:Organizational Culture; D010353:Patient Education as Topic; D011322:Primary Prevention; D036301:Qualitative Research; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D012736:Sex Education; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000628:therapy*; D011795:Surveys and Questionnaires