A study led by a Boston University School of Public Health (BUSPH) researcher found that universal health coverage and changes in the way Massachusetts funds clinics that test for sexually transmitted infections (STIs) have led to a shift in patients accessing testing that has both positive and negative implications.
The study, published in the journal Sexually Transmitted Diseases and led by Dr. Mari-Lynn Drainoni, associate professor of health policy and management at BUSPH, found that reductions in state funding and the imposition of fees at STI clinics in 2009 led to a 20 percent decrease in clinic visits. At the same time, STI visits to primary care providers doubled, while there was no increase in visit volume to the emergency room or OB/GYNs.
Dr. Drainoni and colleagues said some aspects of the shift were encouraging: “Increased use of health insurance for STI-related care in the ‘medical home’ may help remove some of the stigma associated with use of these services in segregated specialty clinic settings,” they wrote. But they also found that the drop in patients seen in the STI clinic was not offset by increases in other settings.
“Patients formerly seen in the STI clinic may be delaying or forgoing care, potentially putting themselves and others at risk for disease transmission,” the researchers said, noting that past studies have found that even the imposition of small co-payments could discourage patient visits.