Gender differences in the utilization of health-care services among the older adult population of Spain.
Identifieur interne : 000608 ( Main/Exploration ); précédent : 000607; suivant : 000609Gender differences in the utilization of health-care services among the older adult population of Spain.
Auteurs : Aurea Redondo-Sendino [Espagne] ; Pilar Guallar-Castill N ; José Ram N Banegas ; Fernando Rodríguez-ArtalejoSource :
- BMC public health [ 1471-2458 ] ; 2006.
Descripteurs français
- KwdFr :
- Acceptation des soins par les patients (statistiques et données numériques), Adulte d'âge moyen (MeSH), Caractéristiques familiales (MeSH), Comportement en matière de santé (MeSH), Enquêtes sur les soins de santé (MeSH), Espagne (épidémiologie), Facteurs socioéconomiques (MeSH), Femelle (MeSH), Humains (MeSH), Maladie chronique (épidémiologie), Mode de vie (MeSH), Modèles logistiques (MeSH), Mâle (MeSH), Médecine de famille (statistiques et données numériques), Odds ratio (MeSH), Qualité de vie (MeSH), Répartition par sexe (MeSH), Services de santé (statistiques et données numériques), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Utilisation médicament (MeSH), Visites à domicile (statistiques et données numériques), Études transversales (MeSH).
- MESH :
- statistiques et données numériques : Acceptation des soins par les patients, Médecine de famille, Services de santé, Visites à domicile.
- épidémiologie : Espagne, Maladie chronique.
- Adulte d'âge moyen, Caractéristiques familiales, Comportement en matière de santé, Enquêtes sur les soins de santé, Facteurs socioéconomiques, Femelle, Humains, Mode de vie, Modèles logistiques, Mâle, Odds ratio, Qualité de vie, Répartition par sexe, Sujet âgé, Sujet âgé de 80 ans ou plus, Utilisation médicament, Études transversales.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Chronic Disease (epidemiology), Cross-Sectional Studies (MeSH), Drug Utilization (MeSH), Family Characteristics (MeSH), Family Practice (statistics & numerical data), Female (MeSH), Health Behavior (MeSH), Health Care Surveys (MeSH), Health Services (statistics & numerical data), House Calls (statistics & numerical data), Humans (MeSH), Life Style (MeSH), Logistic Models (MeSH), Male (MeSH), Middle Aged (MeSH), Odds Ratio (MeSH), Patient Acceptance of Health Care (statistics & numerical data), Quality of Life (MeSH), Sex Distribution (MeSH), Socioeconomic Factors (MeSH), Spain (epidemiology).
- MESH :
- epidemiology : Chronic Disease, Spain.
- statistics & numerical data : Family Practice, Health Services, House Calls, Patient Acceptance of Health Care.
- Aged, Aged, 80 and over, Cross-Sectional Studies, Drug Utilization, Family Characteristics, Female, Health Behavior, Health Care Surveys, Humans, Life Style, Logistic Models, Male, Middle Aged, Odds Ratio, Quality of Life, Sex Distribution, Socioeconomic Factors.
Abstract
BACKGROUND
Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of gender differences in the utilization of health-care services among the elderly.
METHODS
Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of gender differences in the utilization of health services were classified into predisposing factors (age and head-of-family status), need factors (lifestyles, chronic diseases, functional status, cognitive deficit and health-related quality of life (HRQL)) and enabling factors (educational level, marital status, head-of-family employment status and social network). Relative differences in the use of each service between women and men were summarized using odds ratios (OR), obtained from logistic regression. The contribution of the variables of interest to the gender differences in the use of such services was evaluated by comparing the OR before and after adjustment for such variables.
RESULTS
As compared to men, a higher percentage of women visited a medical practitioner (OR: 1.24; 95% confidence limits (CL): 1.07-1.44), received home medical visits (OR: 1.67; 95% CL: 1.34-2.10) and took > or = 3 medications (OR: 1.54; 95% CL: 1.34-1.79), but there were no gender differences in hospital admission or influenza vaccination. Adjustment for need or enabling factors led to a reduction in the OR of women compared to men for utilization of a number of services studied. On adjusting for the number of chronic diseases, the OR (95% CL) of women versus men for ingestion of > or = 3 medications was 1.24 (1.06-1.45). After adjustment for HRQL, the OR was 1.03 (0.89-1.21) for visits to medical practitioners, 1.24 (0.98-1.58) for home medical visits, 0.71 (0.58-0.87) for hospitalization, and 1.14 (0.97-1.33) for intake of > or = 3 medications. After adjustment for the number of chronic diseases and HRQL, the OR of hospitalization among women versus men was 0.68 (0.56-0.84).
CONCLUSION
The factors that best explain the greater utilization of health-care services by elderly women versus men are the number of chronic diseases and HRQL. For equal need, certain inequality was observed in hospital admission, in that it proved less frequent among women.
DOI: 10.1186/1471-2458-6-155
PubMed: 16780576
PubMed Central: PMC1525176
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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type="university">Université autonome de Madrid</orgName></affiliation></author><author><name sortKey="Guallar Castill N, Pilar" sort="Guallar Castill N, Pilar" uniqKey="Guallar Castill N P" first="Pilar" last="Guallar-Castill N">Pilar Guallar-Castill N</name></author><author><name sortKey="Banegas, Jose Ram N" sort="Banegas, Jose Ram N" uniqKey="Banegas J" first="José Ram N" last="Banegas">José Ram N Banegas</name></author><author><name sortKey="Rodriguez Artalejo, Fernando" sort="Rodriguez Artalejo, Fernando" uniqKey="Rodriguez Artalejo F" first="Fernando" last="Rodríguez-Artalejo">Fernando Rodríguez-Artalejo</name></author></analytic><series><title level="j">BMC public health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Chronic Disease 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(MeSH)</term><term>Caractéristiques familiales (MeSH)</term><term>Comportement en matière de santé (MeSH)</term><term>Enquêtes sur les soins de santé (MeSH)</term><term>Espagne (épidémiologie)</term><term>Facteurs socioéconomiques (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Maladie chronique (épidémiologie)</term><term>Mode de vie (MeSH)</term><term>Modèles logistiques (MeSH)</term><term>Mâle (MeSH)</term><term>Médecine de famille (statistiques et données numériques)</term><term>Odds ratio (MeSH)</term><term>Qualité de vie (MeSH)</term><term>Répartition par sexe (MeSH)</term><term>Services de santé (statistiques et données numériques)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Utilisation médicament (MeSH)</term><term>Visites à domicile (statistiques et données numériques)</term><term>Études transversales (MeSH)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Chronic Disease</term><term>Spain</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Family Practice</term><term>Health Services</term><term>House Calls</term><term>Patient Acceptance of Health Care</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Acceptation des soins par les patients</term><term>Médecine de famille</term><term>Services de santé</term><term>Visites à domicile</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Espagne</term><term>Maladie chronique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Cross-Sectional Studies</term><term>Drug Utilization</term><term>Family Characteristics</term><term>Female</term><term>Health Behavior</term><term>Health Care Surveys</term><term>Humans</term><term>Life Style</term><term>Logistic Models</term><term>Male</term><term>Middle Aged</term><term>Odds Ratio</term><term>Quality of Life</term><term>Sex Distribution</term><term>Socioeconomic Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Caractéristiques familiales</term><term>Comportement en matière de santé</term><term>Enquêtes sur les soins de santé</term><term>Facteurs socioéconomiques</term><term>Femelle</term><term>Humains</term><term>Mode de vie</term><term>Modèles logistiques</term><term>Mâle</term><term>Odds ratio</term><term>Qualité de vie</term><term>Répartition par sexe</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Utilisation médicament</term><term>Études transversales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of gender differences in the utilization of health-care services among the elderly.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of gender differences in the utilization of health services were classified into predisposing factors (age and head-of-family status), need factors (lifestyles, chronic diseases, functional status, cognitive deficit and health-related quality of life (HRQL)) and enabling factors (educational level, marital status, head-of-family employment status and social network). Relative differences in the use of each service between women and men were summarized using odds ratios (OR), obtained from logistic regression. The contribution of the variables of interest to the gender differences in the use of such services was evaluated by comparing the OR before and after adjustment for such variables.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>As compared to men, a higher percentage of women visited a medical practitioner (OR: 1.24; 95% confidence limits (CL): 1.07-1.44), received home medical visits (OR: 1.67; 95% CL: 1.34-2.10) and took > or = 3 medications (OR: 1.54; 95% CL: 1.34-1.79), but there were no gender differences in hospital admission or influenza vaccination. Adjustment for need or enabling factors led to a reduction in the OR of women compared to men for utilization of a number of services studied. On adjusting for the number of chronic diseases, the OR (95% CL) of women versus men for ingestion of > or = 3 medications was 1.24 (1.06-1.45). After adjustment for HRQL, the OR was 1.03 (0.89-1.21) for visits to medical practitioners, 1.24 (0.98-1.58) for home medical visits, 0.71 (0.58-0.87) for hospitalization, and 1.14 (0.97-1.33) for intake of > or = 3 medications. After adjustment for the number of chronic diseases and HRQL, the OR of hospitalization among women versus men was 0.68 (0.56-0.84).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The factors that best explain the greater utilization of health-care services by elderly women versus men are the number of chronic diseases and HRQL. For equal need, certain inequality was observed in hospital admission, in that it proved less frequent among women.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16780576</PMID><DateCompleted><Year>2006</Year><Month>08</Month><Day>09</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>01</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2458</ISSN><JournalIssue CitedMedium="Internet"><Volume>6</Volume><PubDate><Year>2006</Year><Month>Jun</Month><Day>16</Day></PubDate></JournalIssue><Title>BMC public health</Title><ISOAbbreviation>BMC Public Health</ISOAbbreviation></Journal><ArticleTitle>Gender differences in the utilization of health-care services among the older adult population of Spain.</ArticleTitle><Pagination><MedlinePgn>155</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of gender differences in the utilization of health-care services among the elderly.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of gender differences in the utilization of health services were classified into predisposing factors (age and head-of-family status), need factors (lifestyles, chronic diseases, functional status, cognitive deficit and health-related quality of life (HRQL)) and enabling factors (educational level, marital status, head-of-family employment status and social network). Relative differences in the use of each service between women and men were summarized using odds ratios (OR), obtained from logistic regression. The contribution of the variables of interest to the gender differences in the use of such services was evaluated by comparing the OR before and after adjustment for such variables.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">As compared to men, a higher percentage of women visited a medical practitioner (OR: 1.24; 95% confidence limits (CL): 1.07-1.44), received home medical visits (OR: 1.67; 95% CL: 1.34-2.10) and took > or = 3 medications (OR: 1.54; 95% CL: 1.34-1.79), but there were no gender differences in hospital admission or influenza vaccination. Adjustment for need or enabling factors led to a reduction in the OR of women compared to men for utilization of a number of services studied. On adjusting for the number of chronic diseases, the OR (95% CL) of women versus men for ingestion of > or = 3 medications was 1.24 (1.06-1.45). After adjustment for HRQL, the OR was 1.03 (0.89-1.21) for visits to medical practitioners, 1.24 (0.98-1.58) for home medical visits, 0.71 (0.58-0.87) for hospitalization, and 1.14 (0.97-1.33) for intake of > or = 3 medications. After adjustment for the number of chronic diseases and HRQL, the OR of hospitalization among women versus men was 0.68 (0.56-0.84).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The factors that best explain the greater utilization of health-care services by elderly women versus men are the number of chronic diseases and HRQL. For equal need, certain inequality was observed in hospital admission, in that it proved less frequent among women.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Redondo-Sendino</LastName><ForeName>Aurea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain. aurea.redondo@uam.es</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guallar-Castillón</LastName><ForeName>Pilar</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Banegas</LastName><ForeName>José Ramón</ForeName><Initials>JR</Initials></Author><Author ValidYN="Y"><LastName>Rodríguez-Artalejo</LastName><ForeName>Fernando</ForeName><Initials>F</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2006</Year><Month>06</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Public Health</MedlineTA><NlmUniqueID>100968562</NlmUniqueID><ISSNLinking>1471-2458</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002908" MajorTopicYN="N">Chronic Disease</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004363" MajorTopicYN="N">Drug Utilization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005191" MajorTopicYN="N">Family Characteristics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005194" MajorTopicYN="N">Family Practice</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015438" MajorTopicYN="N">Health Behavior</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019538" MajorTopicYN="N">Health Care Surveys</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006296" MajorTopicYN="N">Health Services</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006792" MajorTopicYN="N">House Calls</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008019" MajorTopicYN="N">Life Style</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010342" MajorTopicYN="N">Patient Acceptance of Health Care</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017678" MajorTopicYN="N">Sex Distribution</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012959" MajorTopicYN="N">Socioeconomic Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N">Spain</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2005</Year><Month>09</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2006</Year><Month>06</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2006</Year><Month>6</Month><Day>20</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2006</Year><Month>8</Month><Day>10</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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IdType="pubmed">10048840</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li></country><region><li>Communauté de Madrid</li></region><settlement><li>Madrid</li></settlement><orgName><li>Université autonome de Madrid</li></orgName></list><tree><noCountry><name sortKey="Banegas, Jose Ram N" sort="Banegas, Jose Ram N" uniqKey="Banegas J" first="José Ram N" last="Banegas">José Ram N Banegas</name><name sortKey="Guallar Castill N, Pilar" sort="Guallar Castill N, Pilar" uniqKey="Guallar Castill N P" first="Pilar" last="Guallar-Castill N">Pilar Guallar-Castill N</name><name sortKey="Rodriguez Artalejo, Fernando" sort="Rodriguez Artalejo, Fernando" uniqKey="Rodriguez Artalejo F" first="Fernando" last="Rodríguez-Artalejo">Fernando Rodríguez-Artalejo</name></noCountry><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Redondo Sendino, Aurea" sort="Redondo Sendino, Aurea" uniqKey="Redondo Sendino A" 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