Gender differences in general practice utilisation in New Zealand
Gender differences in general practice utilisation in New Zealand
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DOI：
10.1071/hc09261
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发表时间：
2009-12-01
影响因子：
1.2
通讯作者：
Crampton, Peter
中科院分区：
文献类型：
--
作者：
Jatrana, Santosh;Crampton, Peter
引言：本文旨在考察新西兰全科医生使用情况的性别差异。方法：本研究的数据来自于2001年至2002年进行的全国具有代表性的多阶段全科医生和患者就诊抽样调查(NatMedCa)，该调查收集了246名全科医生(GP)的10506份访问记录。在过去12个月中，那些在过去12个月中至少去看过一次全科医生的患者中，全科医生的就诊次数被用作结果变量。结果：在过去的12个月中，女性比男性更有可能去看全科医生(IRR=1.13；95%CI：1.03-1.24)。我们还发现，即使排除了妇科和产科疾病，而且在所有年龄组中，女性对全科医生服务的利用也明显过剩。亚洲女性去看全科医生的可能性比欧洲女性低39%(IRR=0.61；95%CI：0.43-0.85)；这一结果在男性对全科医生服务的利用中没有反映出来。此外，我们还发现，与“自我限制”问题相比，去全科医生就诊的女性报告有“危及生命的”问题的可能性高39%(IRR=1.39；95%CI：1.00-1.94)。结论：我们的结果不支持文献中的观点，即女性过度使用服务的主要原因是妇产科疾病，或者女性过度就诊主要集中在育龄阶段。种族和问题的严重性在很大程度上解释了女性使用全科医生的情况，而不是男性。
INTRODUCTION: This paper aims to examine gender differences in general practice utilisation in New Zealand.METHODS: The dataforthis research came from 10 506 visit records gathered from 246 general practitioners (GPs) who took part in the National Primary Medical Care Survey (NatMedCa), a nationally representative, multistage, probability sample survey of GPs and patient visits conducted in 2001/2002. The number of visits to a general practice in the last 12 months among those patients who visited the GP at least once during the past 12 months was used as the outcome variable. Poisson regression was used for analysis.RESULTS: Women were more likely than men to visit a GP over the last 12 months (IRR=1.13; 95% CI: 1.03-1.24). We also found significant female excess in utilisation of GP services even after excluding gynaecological and obstetric conditions and across all age groups. Asian were 39% less likely than European women to visit a GP (IRR=0.61; 95% CI: 0.43-0.85); a result that was not reflected in men's utilisation of GP services. In addition, we found that women visiting GPs were 39% more likely to have reported 'life-threatening' problems as compared to 'self-limiting' problems (IRR=1.39; 95% CI: 1.00-1.94).CONCLUSION: Our results do not support the body of literature that suggests that women's excess in service use can largely be attributed to gynaecological and obstetrical conditions or that the female excess in visits is focussed in the childbearing years. Ethnicity and the severity of a problem contributed significantly to explaining women's, but not men's, utilisation of GPs.