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. 2015 Jun;28(3):144-8.
doi: 10.1016/j.jpag.2014.06.005. Epub 2014 Jun 25.

Impact of Post-visit Contact on Emergency Department Utilization for Adolescent Women with a Sexually Transmitted Infection

Jennifer L Reed  1 , Mohsin A Zaidi  2 , Tiffany D Woods  3 , Justin R Bates  4 , Maria T Britto  4 , Jill S Huppert  5
Affiliations

Impact of Post-visit Contact on Emergency Department Utilization for Adolescent Women with a Sexually Transmitted Infection

Jennifer L Reed et al. J Pediatr Adolesc Gynecol. 2015 Jun.

Abstract

Study objectives: To understand Emergency Department (ED) utilization patterns for women who received sexually transmitted infection (STI) testing and explore the impact of post-visit telephone contact on future ED visits.

Design, setting, participants: We performed a secondary analysis on a prospectively collected dataset of ED patients ages 14-21 years at a children's hospital.

Interventions and main outcome measures: The dataset documented initial and return visits, STI results, race, age and post-visit contact success (telephone contact ≤7 days of visit). Logistic regression was performed identifying variables that predicted a return visit to the ED, a return visit with STI testing, and subsequent positive STI results.

Results: Of 922 women with STI testing at their initial ED visit, 216 (23%) were STI positive. One-third (315/922) returned to the ED, 15% (141/922) returned and had STI testing, and 4% (38/922) had a subsequent STI. Of 216 STI-positive women, 59% were successfully contacted. Of those who returned to the ED, age ≥ 18 and Black race were associated with increased STI testing at a subsequent visit. Successful contact reduced the likelihood of STI testing at a subsequent ED visit (OR 0.28, 95% CI 0.01-0.8), and ED empiric antibiotic treatment had no effect on subsequent STI testing.

Conclusion: Contacting women with STI results and counseling them regarding safe sex behaviors may reduce the number of ED patients who return with symptoms or a new exposure necessitating STI testing. The high STI prevalence and frequent return rate suggest that ED interventions are needed.

Keywords: Adolescents; Emergency department; Health care seeking behavior; Sexually transmitted infections.

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Conflict of interest statement

The authors indicate no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Outcomes for adolescent women seen in the ED with STI testing at the initial visit.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention: 2008 Sexually Transmitted Disease Surveillance. Department of Health and Human Services. November 2009. Available: http://www.cdc.gov/std/stats08/toc.htm. Accessed June 22, 2010.
    1. Huppert JS, Biro F, Lan D, et al.: Urinary symptoms in adolescent females: STI or UTI? J Adolesc Health 2007; 40:418. - PMC - PubMed
    1. Huppert JS, Reed JL, Munafo JK, et al.: Improving notification of sexually transmitted infections: a quality improvement project and planned experiment. Pediatrics 2012; 130:e415. - PMC - PubMed
    1. Beckmann KR, Melzer-Lange MD, Gorelick MH: Emergency department management of sexually transmitted infections in US adolescents: results from the National Hospital Ambulatory Medical Care Survey. Ann Emerg Med 2004; 43:333. - PubMed
    1. Yealy DM, Greene TJ, Hobbs GD: Underrecognition of cervical Neisseria gonorrhoeae and Chlamydia trachomatis infections in the emergency department. Acad Emerg Med 1997; 4:962. - PubMed

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