1. Improvements in STD Services Following the Implementation of an Express Visit
for STD Screening, Maricopa County, Arizona
Arcelia Chacon, Erica Bouton, BS
Maricopa County Department of Public Health, Phoenix, Arizona
Background: One publically funded STD clinic serves a population of approximately
four million in Maricopa County, Arizona. This clinic offers screening and
treatment services for chlamydia, gonorrhea, and syphilis and testing and referral
for HIV. Demand for STD services has risen due to increases in these infections.
Objectives: To evaluate testing and treatment frequencies following the implementation
of a lab-only (Express) visit for asymptomatic patients that present for STD
screening
Methods: In September 2008 the patient triage system at the STD clinic was revised to
route asymptomatic patients that did not report contact to an STD for Express
testing . Patients reporting symptoms or contact to an STD were routed to a
medical provider. Clinic attendance, numbers of patients screened and treated
through Express testing, and the number of patient turn-a-ways were evaluated
before and after the implementation of this system.
Results:
• Following the implementation of Express testing, clinic attendance increased by 15% from
2009 to 2012.
• Treatment completion rates of cases diagnosed through Express testing remained high
(93%, 2009-2012).
• Patient turn-a-ways decreased 99% from year 2009 to year 2012.
Conclusions:
• Increases in clinic attendance and reductions in patient turn-a-ways following the
implementation of Express testing indicate this method resulted in improved service
delivery in a setting of high demand.
• High treatment rates indicate quality of care was preserved following the implementation
of this service.
Implications:
• Express testing may be a valuable option in other health service areas facing resources
challenges in STD services.
Reduction in STD Clinic Patient Turn-a-ways Following
Implementation of Express Testing
STD Clinic Attendance
Following Implementation of Express Testing
Positivity and Treatment Completion Rates
Patients Receiving STD Screening through Express Testing, 2009-2012
0
20
40
60
80
100
120
140
160
180
Turn A-Ways 159 0 8 134 0 81 139116 45 94 0 0 7 0 98 30 30 3 10 0 21 0 13 0 0 0 21 4 2 16 44 89 15 0 0 62 0 0 0 0 0 0 0 0 0 0 6 0
1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12
Maricopa County Public Health Clinic
Treatment
Number Percent Number Completion
Treated Positive Positive Treated Rate
2009 2864 180 6.3% 170 94.4%
2010 2957 202 6.8% 182 90.1%
2011 3653 259 7.1% 236 91.1%
2012 10701 1170 10.9% 1104 94.4%
TOTAL 20175 1811 9.0% 1692 93.4%
2009 2011 20122010
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
22000
Clinic 18115 18432 16379 16146 14436 14455 19580 18555 18522 18418 19682 21077
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
ET Implementation