Background:Patient turnaways occur in walk-in sexually transmitted infection (STI) clinics due to the high demand for services exceeding resources available for the provision of same-day care. To manage patient turnaways, staff provide referrals to other clinics or ask patients to return the following day.
Objectives:To describe the patient population being turned away in municipal STI clinics, to identify barriers, and to assess intent for follow-up.
Methods:A self-administered survey was conducted among patients turned away for care in four Chicago Department of Public Health (CDPH) STI clinics in September 2009.
Results:Preliminary results included responses of 52 patients. Almost half (46%) were first time visitors and 8% were previously turned away on another visit. Median age was 26 (range 16-54) years. Patients were predominantly male (63%) and African-American (71%). By reason for visit, 42% reported current STI symptoms, 12% had a partner with an STI, and 3% were contacted by a health worker. The large majority lacked health insurance (69%) and did not have a regular doctor (79%); nearly half (48%) reported having no income. Patients traveled to the clinic by public transportation (44%) or by car (43%). Half (50%) made special arrangements to attend the clinic, including calling off work (20%) and arranging for childcare (13%). For follow-up care, 13% intended to go to another CDPH clinic the same day, 55% intended to return to the same clinic the following day, and no patients intended to go to another provider.
Conclusions:Patients turned away from municipal STI clinics are predominately uninsured, indigent persons without primary health care, who are symptomatic, and in need of access to STI care.
Implications for Programs, Policy, and/or Research:Understanding the characteristics of patient turnaways can assist programs to improve systems of care to eliminate turnaways from STI clinics, and to better meet the needs of a vulnerable at-risk population.