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2 results

  • Under one roof? A population-based survey of patient use and preference for sexual health services

  • Debra Gray, Catherine H. Mercer, Anna Graham, Rebecca S. French, Chris Salisbury, The One-Stop Shop Project Team
  • Journal:
    Primary Health Care Research & Development / Volume 10 / Issue 3 / July 2009
    Published online by Cambridge University Press:
    01 July 2009, pp. 223-235
    • Article
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  • Aim

    To compare patterns of population service use and preference in areas with and without one-stop shop services.

    Background

    A number of strategy documents have recommended adopting a more integrated approach to sexual health service provision. One proposed model of integration is one-stop shops, where services for contraception and sexually transmitted infections are provided under the same roof. Currently, the potential impact of one-stop shop services on patient service use and preference is unclear, particularly at a population level.

    Method

    Three different models of one-stop shop were studied: a dedicated young persons’ service, a specialist mainstream service, and an enhanced general practice. In each model, the one-stop shop site was matched to two control sites with traditional service provision. Random samples of male and female patients were selected from general practices close to either the one-stop shop or control sites. These patients received a postal survey asking about their use or preference for services for six sexual health needs. One-stop shop and control samples were compared using multivariate logistic regression.

    Findings

    Of the 14 387 patients surveyed, 3101 (21.6%) responded. In the young persons’ model, few significant differences were found in service use or preference between those living in one-stop shop and control site areas. In the specialist services model, women in the one-stop shop area were significantly more likely to cite specialist services for emergency contraception and abortion advice, when compared to those served by non-integrated control services. In the general practice model, respondents in the one-stop shop area were significantly more likely to cite general practice for all six sexual health needs. Overall, general practice was the preferred service provider cited for all sexual health needs, except condoms and pregnancy tests. These findings are discussed in terms of their implications for the provision of integrated sexual health services. In addition, key methodological issues and future research possibilities are identified.

  • 31 - Genitourinary disorders

  • from Part III - Working with specific units
  • Edited by Geoffrey Lloyd, Priory Hospital, London, Elspeth Guthrie, University of Manchester
  • Book:
    Handbook of Liaison Psychiatry
    Published online:
    10 December 2009
    Print publication:
    24 May 2007, pp 733-750

  • Summary

    Genitourinary medicine (GUM) attracted the attention of liaison psychiatrists decades before the emergence of HIV. Although many psychiatrists are accustomed to working in HIV departments, fewer contemporary practitioners have experience of general GUM clinics. The sections of this chapter describes specific illnesses found in GUM settings. Where applicable, the relevance of various International Classification of Disease (ICD)-10 diagnoses is discussed. Almost any psychiatric condition may exist comorbidly in patients attending GUM clinics. The conditions described in the sections are therefore clinical pictures where psychiatry and GUM overlap through more than a chance association. The high levels of psychological disturbance in GUM clinics are not matched by high levels of referral to psychiatrists. Although any number from 20 to 50% of patients may score as distressed, fewer than 1% are referred to mental health services.