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Sexually Transmitted Diseases and Managed Care: An Inquiry and Review of Issues Affecting Service Delivery

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, tlc2{at}cdc.gov

Delia Scholes, PhD

Center for Health Studies, Group Health Cooperative, Seattle, Wash, and Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Wash

June BlueSpruce, MPH

Integrated Group Practice Quality Department, Group Health Cooperative, Seattle, Wash

Belinda H. Operskalski, MPH

Center for Health Studies, Group Health Cooperative, Seattle, Wash

Kathleen Irwin, MD, MPH

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

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.

Key Words: Chlamydia trachomatis • cost • health care • managed care • patient education • prevention • public health • risk assessment • sexually transmitted diseases

American Journal of Medical Quality, Vol. 19, No. 4, 145-156 (2004)
DOI: 10.1177/106286060401900403


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