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Detection-Based Monetary Incentives to Improve Syphilis Screening Uptake: Results of a Pilot Intervention in a High Transmission Setting in Southern China
United States: Copyright American Sexually Transmitted Diseases Association
Erscheinungsjahr
2020
Link zum Volltext
Quelle
Applied Social Sciences Index & Abstracts (ASSIA)
Beschreibungen/Notizen
BACKGROUNDUnderscreening of syphilis in clinical settings is a pervasive problem in resource-constrained settings where heavy patient loads and competing health priorities inhibit health providersʼ ability to meet screening coverage targets. A “detection-based” pay-for-performance (P4P) strategy can incentivize more targeted testing by rewarding providers with a monetary bonus for every confirmed case.
METHODSFive clinics in a high transmission setting of China participated in the 6-month pilot intervention. Seropositive proportions during the P4P intervention were compared with those during the preintervention phase using multilevel logistic regression models adjusted for age and sex of clinic attendees.
RESULTSThere were 8423 patients that sought care at 1 of the 6 clinics over the course of the study. Adjusted odds of a positive syphilis screen were greater during the intervention period compared to the preintervention interval (odds ratio, 1.33; 95% confidence interval, 1.14–1.56). Variability in clinic-level effects was substantial given the small number of sites of this pilot study.
CONCLUSIONSResults of this detection-based P4P pilot study demonstrate the feasibility and preliminary effectiveness of this approach for improving syphilis case detection in resource-constrained clinical settings. A fully powered randomized trial is needed to inform the full utility of this approach for improving sexually transmitted disease detection globally.