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Sexually transmitted infections -- factors associated with quality of care among private general practitioners
H Schneider1, N Chabikuli, D Blaauw
1Centre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa. helen.schneider@nhls.ac.za
Objectives:
To study the factors associated with quality of sexually transmitted infection (STI) care among private general practitioners in Gauteng.
Methods:
We analysed 1 194 records of patients attending 26 randomly selected GP practices in the first 3 months of 2000 and 2002, for 3 STI syndromes, namely urethral discharge, pelvic inflammatory disease and genital ulcers. We assessed adherence to nationally accepted STI treatment guidelines and analysed the influence of patient and practice-level variables on effectiveness of STI drug regimens and trends over time.
Results:
After controlling for syndrome mix, district and time period, appropriate drug treatment for STIs was significantly associated with the client having medical aid (p < 0.001), recent graduation as a medical practitioner (p < 0.001) and male GP gender (p = 0.007). Between 2000 and 2002, STI care improved for clients with medical aids but for not cash clients.
Conclusions:
There was variation in the quality of prescribing for STIs among GPs and positive trends in this prescribing. There is a need for interventions that address the financial incentives that may hamper quality of STI care for cash clients.
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