Gender differences in Healthcare-Seeking Behavior for urinary incontinence and the impact of socioeconomic status - A study of the medicare managed care population
Gender differences in Healthcare-Seeking Behavior for urinary incontinence and the impact of socioeconomic status - A study of the medicare managed care population
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DOI：
10.1097/mlr.0b013e31812da820
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发表时间：
2007-11-01
期刊：
影响因子：
3
通讯作者：
Mukamel, Dana B.
中科院分区：
文献类型：
--
作者：
Li, Yue;Cai, Xueya;Mukamel, Dana B.
背景资料：尽管在社区生活的老年人中尿失禁（UI）的病因、患病率和管理方面存在性别差异，但性别对其就医行为的影响知之甚少。目的：确定专业护理寻求、接受UI治疗方面的性别差异，以及年龄和社会经济地位的影响。2003年和2004年全国医疗保险管理医疗登记者调查。对象：共28,724例非住院患者，年龄65岁及以上。结果：与男性尿失禁患者相比，女性尿失禁患者因尿失禁问题寻求专业帮助的可能性更小[46.2%对55.7%;经校正的比值比（AOR）= 0.65，P < 0.01]，但在咨询健康专业人员后更有可能接受治疗（54.8% vs. 51.4%; AOR = 1.12，P < 0.01）。这些性别差异因年龄、教育或家庭年收入水平而异。对于失禁的妇女，接受治疗的预测率下降，年龄较大，教育程度较低，收入水平较低。结论：社区生活的老年妇女UI问题不太可能寻求专业帮助比男性同行，但更有可能治疗后，一个健康的专业人士咨询。患者的社会经济地位会影响医生的行为，并最终影响他们接受UI治疗，尤其是女性。目前的努力，以促进认识和质量的照顾UI中老年人应占性别和其他社会人口因素。
Background: Despite the gender difference in etiology, prevalence and management of urinary incontinence (UI) among community-living older adults, little is known about the effect of gender on their healthcare-seeking behaviors.Objective: To determine gender differences in professional care seeking, receipt of UI treatment, and the impact of age and socioeconomic status.Research Design: National survey of Medicare managed care enrollees in 2003 and 2004.Subjects: A total of 28,724 patients who were noninstitutionalized, age 65 and older. and had self-reported UI problem in the last 6 months.Measures: Whether a patient with UI had discussed the problem with a health provider, and whether a patient having had such discussion received treatment.Results: Compared with incontinent men, incontinent women were less likely to seek professional help for the UI problem [46.2% vs. 55.7%; adjusted odds-ratio (AOR) = 0.65, P < 0.01], but more likely to receive treatment (54.8% vs. 51.4%; AOR = 1.12, P < 0.01) after consulting a health professional. These gender differences varied by age, education, or annual household income level. For incontinent women, the predicted rate of receiving treatment decreased with older age, lower education, and lower income level.Conclusions: Community-living older women with UI problem are less likely to seek professional help than their male counterparts, but more likely to be treated after a health professional is consulted. Patients' socioeconomic status can affect physician behavior and ultimately, their receipt of treatment of UI, especially for women. Current efforts to promote awareness and quality-of-care of UI among older adults should account for gender and other sociodemographic factors.