Under one roof? A population-based survey of patient use and preference for sexual health services

Abstract

Aim: To compare patterns of population service use and preference in areas with and without one-stop shop services. Background: A number of strategy documents have recommended adopting a more integrated approach to sexual health service provision. One proposed model of integration is one-stop shops, where services for contraception and sexually transmitted infections are provided under the same roof. Currently, the potential impact of one-stop shop services on patient service use and preference is unclear, particularly at a population level. Method: Three different models of one-stop shop were studied: a dedicated young persons' service, a specialist mainstream service, and an enhanced general practice. In each model, the one-stop shop site was matched to two control sites with traditional service provision. Random samples of male and female patients were selected from general practices close to either the one-stop shop or control sites. These patients received a postal survey asking about their use or preference for services for six sexual health needs. One-stop shop and control samples were compared using multivariate logistic regression. Findings: Of the 14 387 patients surveyed, 3101 (21.6%) responded. In the young persons' model, few significant differences were found in service use or preference between those living in one-stop shop and control site areas. In the specialist services model, women in the one-stop shop area were significantly more likely to cite specialist services for emergency contraception and abortion advice, when compared to those served by non-integrated control services. In the general practice model, respondents in the one-stop shop area were significantly more likely to cite general practice for all six sexual health needs. Overall, general practice was the preferred service provider cited for all sexual health needs, except condoms and pregnancy tests. These findings are discussed in terms of their implications for the provision of integrated sexual health services. In addition, key methodological issues and future research possibilities are identified.

From ‘holding pen’ to ‘a space to breathe’: affective landscapes in a newly‐integrated sexual health clinic

“…Existing studies focus overwhelmingly on the ‘One‐Stop Shop’ (hereafter OSS) – a model of service provision wherein a full range of services are brought together ‘under one roof’ and care is provided by comprehensively trained practitioners (Gray et al . ). Studies have discussed a number of concerns that influence attendees’ preferences for, or rejection of, integrated services over ‘stand‐alone’ options, including the location and accessibility of the clinic (French et al .…”

“…Existing studies focus overwhelmingly on the 'One-Stop Shop' (hereafter OSS)a model of service provision wherein a full range of services are brought together 'under one roof' and care is provided by comprehensively trained practitioners (Gray et al 2009). Studies have discussed a number of concerns that influence attendees' preferences for, or rejection of, integrated services over 'stand-alone' options, including the location and accessibility of the clinic (French et al 2006), staff attitudes (Griffiths et al 2008), interpersonal relationships and the presence of other attendees (Griffiths et al 2008), competency of delivery and confidentiality (Griffiths et al 2008) and stigma (Gray et al 2009, Sauer et al 2013. Summarising key concerns, it is clear that stakeholders are worried about possible changes in the clinic environment, staff attitudes and expertise, and the presence of 'others' in these new facilities.…”

Addressing sexual health needs: a comparison of a one-stop shop with separate genitourinary medicine and family planning services

“…In line with the case study approach, as in previous publications, 9,11 these analyses compare the one-stop shop sample with its corresponding GUM/contraceptive clinic control sites, considered in the analysis as one sample. We examine the outcomes of the consultation by the reason questionnaire respondents gave for attending the service.…”