Integration of Family Planning Services into an STD Clinic Setting

Background: STDs and unintended pregnancy are significant and costly public health concerns. Integrating family planning services (FPS) into STD visits provides an opportunity to address both concerns simultaneously although the feasibility and acceptance of integration has not been established. Denver Metro Health Clinic (DMHC) has utilized Title X funding to offer initial FPS with STD services for at-risk populations.

Objectives: To measure utilization of FPS among STD clients seen at DMHC, measure additional time required to offer FPS, assess staff perceptions of providing integrated services, and identify strategies that facilitate integrating FPS and STD services in STD clinics. Methods: Retrospective chart review, clinic observations, time study, and qualitative interviews of staff.

Results: Between 1/06-12/09, 29,453 clients eligible for FPS were seen (38% female, 62% male). Among those eligible, 52% received FPS, with similar proportion of FPS provided to males (52.1%) and females (51.4%)(p=0.14). Each year, the proportion of eligible patients receiving FPS increased (2006: 36.8%, 2007: 44.4%, 2008: 50.8%; 2009: 79.2%; p<0.01). Staff value being able to provide these complementary services simultaneously to at-risk populations. Efficient staffing plans, streamlined clinic flow, and automatic identification of FP eligibility through an integrated electronic medical record allow staff to integrate these services using on average only six additional minutes per patient.

Discussion: Integration of FPS with STD services is feasible in an STD clinic and provides two valuable services to at-risk populations in one visit. Thoughtful staffing, efficient clinic flow, an integrated medical record facilitate efficient provision of FPS with STD services.