CLIENT FOLLOW-UP AT THE ADELAIDE SEXUALLY-TRANSMITTED DISEASE CLINIC

This study investigated the extent to which doctor-client communicatio n is associated with follow-up rates at Clinic 275, an Adelaide sexual ly transmitted diseases (STD) clinic. At Clinic 275, clients are routi nely screened for the major STDs at their first visit. They are then a sked to return in one week's time for their results and further treatm ent if necessary. Over a four-week period in April-May 1994, the clini cal consultations between doctors and 100 clients attending for their first visit in an episode of care were observed and recorded. Data fro m the observation schedules were matched with data collected from inte rviews, either when clients returned for their follow-up visit (n = 78 ) or from a telephone interview when they failed to return (n = 20). I n addition, 18 clients who failed to return for follow-up (but were no t part of the original observation sample) were interviewed. Sociodemo graphic factors did not affect follow-up rates. Of those who did not r eturn for follow-up, social and environmental reasons were cited by ab out two-thirds. Reasons given by the remaining clients indicate that f ailure to return for follow-up was related to discrepancies in doctor- client communication in that they were confused about the need to retu rn to obtain test results. In addition, approximately half could not n ame the infections for which they had been tested. Changes in clinic p ractice may prove a more useful method of increasing follow-up rates t han seeking to identify the characteristics of noncompliant individual s.