An Examination of Populations who Access STD-Related Services at Two City Health Clinics and a Strategy for Maintaining these Clinics in the Era of the Patient Protection and Affordable Care Act of 2010

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Albert Crawford, PhD, MBA, MS, Thomas Jefferson University (Chair)

Lenore Asbel, MD, Medical Director, STD Control, Philadelphia Department of Public Health (Preceptor)


There are over 19 million new cases of sexually transmitted diseases (STDs) reported each year in the United State and Philadelphia ranks in the top ten in STD rates amongst large US cities. Philadelphia Department of Public Health (PDPH) operates two categorical STD clinics which provide free STD services to more than 13,000 individuals annually. Recently, the Patient Protection and Affordable Care Act (ACA) of 2010 shifted the funding landscape for Local Health Department clinics with many jurisdictions experiencing loss of resources and reduction in staff due to budget cuts. This study examined populations who seek care at the two PDPH clinics to show the need for future maintenance of these clinics and offer strategies for maintaining existing services. 727 self-administered patient surveys were collected in Fall 2012. Data were gathered regarding patients’ reasons for accessing care at these clinics, socio-economic status, health insurance status, and amenability to having their health insurance billed for services. Additional data were gathered from the STD clinic database in order to show that respondents were representative of clinic population and to further elucidate factors in the context of study aims. Results identified several factors affecting use of clinics by patients and provided insight into future use of these clinics. Free services, previous clinic attendance, confidentiality, and specialization of the clinics were the most frequently reported reasons patients chose these clinics. Based on findings, it can be concluded that these clinics will remain a primary point of STD health care access for patients in the era of the ACA and strategies will need to be adopted to generate revenue to support these clinics. Furthermore, results of this study support the need for coexistence of categorical STD clinics with primary care physicians in the future.

Presentation: 26 minutes