公立医疗机构性病服务质量调查

目的 对四川、云南试点地区公立医疗机构性病服务质量进行调查评估，以便为改善性病服务质量和开展有针对性的干预提出建议。方法 在四川、云南的6个试点地区选择所有性病专科门诊和部分综合医院皮肤科、泌尿科、妇产科作为被调查单位，直接观察和访谈医生了解医生处理性病病例的过程。结果 通过观察81位医生对76例性病及5例阴道分泌物异常伴下腹痛病例处理过程和访谈94位医生，按照WHO／GPA评估指标，规范处理病人的比例较低(PI—6)四川为10％，云南为14．3％，主要是过度治疗，也有一定比例的错误治疗。建议使用安全套和性伴通知的比例(PI—7)四川为88．3％，云南为57．1％。总体服务质量(PI—6 7)，四川为10．0％，云南为4．8％。结论 公立医疗机构包括综合医院和性病专科医院的医生在性病规范诊疗方面工作较差，预防服务意识不强。今后应加强对医务人员的性病艾滋病专业培训，进一步提高性病服务质量。

Survey on STI service quality of public medical institutions

ObjectiveSurvey and assessment were conducted to the STI service quality of public medical institutions at the pilot Sichuan and Yunnan, so as to inform and advise on improvement of STI services and targeted intervent ions.MethodsAll STD clinics and the dermatology departments,u rology departments and obstetrics and gynecology departments of some general hos pi tal at the six sites in Sichuan and Yunnan were surveyed.Management of STI cases by the doctors at the surveyed medical institutions was studied by direct obser vation on interviews with the doctors. ResultsTotally 81 doctors from public medical institutio ns were observed for their diagnosis and treatment of 76 STD cases and 5 cases o f GDS and lower abdominal pain.In addition,94 doctors were interviewed.According to the assessment indicators of WHO/GPA,the proportion of standardized case man agement remained low (PI-6) with over-treatment and a few cases of improper trea tment,specifically,10% in Sichuan and 14.3% in Yunnan.The proportion of doctors who recommended condom use and partner notification (PI-7) was 88.3% in Sichuan and 57 1% in Yunan.The rate for overall service quality (PI-6+7) was 10.0% in S ichuan and 4.8% in Yunnan. ConclusionThe STD diagnosis and treatment provided by do c tors at public medical institutions including STD clinics and general hospitals were not satisfactory.Consciousness prevention of services was weak.It was neces sary to reinforce the professional trainings for medical staff on diagnosis and treatment of STD/AIDS,and to further improve the quality of STD services.