上海市徐汇区性病服务质量再评估

目的 为了评价上海市在近些年中性病相关的政策和具体措施对性病服务质量产生的影响,为今后的性病决策提供科学依据,我们于1996年和1999年对该市的徐汇区的公立性病服务质量进行了两次评估。方法 采用定性和定量的研究方法,以统一的问卷对所有的性病服务机构进行调查,以统一的访谈提纲对部分机构进行深入访谈。定量资料用SAS软件分析。结果 1996年～1999年期间性病服务质量得到明显改善:设置性病专科门诊的机构从26.3％增至38.1％;配有男、女性病专科医生由68.4％和73.7％分别增加到90.5％和95.2％;临床和实验室医生受专科培训的比例增加;复诊率由1996年的36.3％增至1999年的57.1％;淋病的诊断方法1996年以涂片为主,1999年则以培养为主,衣原体的诊断方法1996年以病征处理为主,而1999年以金标法为主;支原体的诊断方法1996年以病征处理为主,而1999年以培养为主;1999年100％的性病服务门诊建议使用或提供避孕套、及鼓励性伴同治,1996年分别为15.8％和78.9％;提供咨询服务从68.4％增至90.5％。结论 本研究提示加强机构建设、人员培训、依法管理等促进了性病服务质量的改善;在今后的卫生体制改革中,应继续加强性病防治三级网络的机构和功能的建设。

Re- evaluation of STD Service Quality in Xuhui District of Shanghai

Objective To understand the impact of STD related policies and measures on the service quality in the past years in Shanghai, provide sicientific information for policy making, the STD services provided by all public STD clinics in Shanghai in 1996 and 1999 were evaluated. Methods Both quantitative and qualitative study were employed, a questionnaire survey were conducted in all clinics and in - depth interviews in part of them. The data obtained were analyzed by using software SAS. Results Overall, the quality of STD service in Xuhui District had been greatly improved between the years of 1996 and 1999. The proportion of setting up STD specialist clinics increased from 26.3% in 1996 to 38.1% in 1999. The rate of the permanent male and female STD doctors had risen from 68.4 % and 73.7 % in 1996 to 90.0 % and 95.0 % in 1999, respectively. The increased rate of STD special training for physicians and laboratory technicians were observed. The rates of simultaneous treatment for sexual partners increased from 36.3% in 1996 to 57.1% in 1999, respectively, existing a significant difference between them ( p <0.05). The major diagnosing method for gonorrhoea switched from smearing in 1996 to culturing in 1999, and for chlamydia from syndromic approach in 1996 to labeled golden in 1999 and for mycoplasma from syndromic approach in 1996 to culturing in 1999. 100% STD clinics promoted condom use and advised STD patients with their sexual partners for simultaneous treatment in 1999, whereas in 1996 both were 15.8% and 78.9%, respectively. 90.5 % clinics provided STD counseling in 1999 while 68.4 % in 1996. Conclusion It is implied that opening STD specialist clinics, training STD professional staff, managing STD services by laws and strengthening organizational building contribute to promotion of the improvement of the quality of STD services in Xuhui, and the persistent emphasis of them be given to three- level network of STD prevention and treatment in Shanghai in the future health reform.