title: A retrospective cross-sectional study of patients treated in US EDs and ambulatory care clinics with sexually transmitted infections from 2001 to 2010.
abstract: BACKGROUND
  Sexually transmitted infections (STIs) are commonly seen in the ambulatory health care settings such as emergency departments (EDs) and outpatient clinics. Our objective was to assess trends over time in the incidence and demographics of STIs seen in the ED and outpatient clinics compared with office-based clinics using the National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey.
  
  
  METHODS
  This study was conducted using 10 years of National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey data (2001-2010). We compared data from 2001-2005 to data from 2006-2010. Patients were included in analyses if they were 15 years and older and had an International Classification of Diseases, Ninth Revision code consistent with cervicitis, urethritis, chlamydia, gonorrhea, or trichomonas.
  
  
  RESULTS
  We analyzed 82.4 million visits for STIs, with 16.5% seen in hospital-based EDs and 83.5% seen in office-based clinics between 2001 and 2010. Compared with patients seen in office-based clinics, ED patients were younger (P< .05), more likely to be male (P< .001) and nonwhite (P< .001), and less likely to have private insurance (P< .05). We found a significant increase in adolescent (15-18 years) ED visits (P< .05) from 2001-2015 to 2006-2010 and a decrease in adolescent and male STI visits in office-based settings (P< .05).
  
  
  CONCLUSIONS
  Although patients with STI are most commonly seen in office-based clinics, EDs represent an important site of care. In particular, ED patients are relatively younger, male, and nonwhite, and less likely to be private insured.
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Chelsea E
authors.initials: CE
authors.lastname: Ware
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Ajabnoor
authors.affiliation: Office for Clinical Practice Innovation, The George Washington University, Washington, DC.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Mullins
authors.affiliation: Medstar Health Research Institute, Washington, DC.
authors.forename: Maryann
authors.initials: M
authors.lastname: Mazer-Amirshahi
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC; Office for Clinical Practice Innovation, The George Washington University, Washington, DC.
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Pines
authors.affiliation: Department of Emergency Medicine, University of California-Davis, Washington, DC. Electronic address: larissa.may@gmail.com.
authors.forename: Larissa
authors.initials: L
authors.lastname: May
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities; D002690:Chlamydia Infections / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D014245:Trichomonas Infections / Q000453:epidemiology; D014247:Trichomonas Vaginitis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014526:Urethritis / Q000453:epidemiology*; D002575:Uterine Cervicitis / Q000453:epidemiology*; D055815:Young Adult