Do men consult less than women? An analysis of routinely collected UK general practice data
Do men consult less than women? An analysis of routinely collected UK general practice data
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DOI：
10.1136/bmjopen-2013-003320
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发表时间：
2013-01-01
期刊：
影响因子：
2.9
通讯作者：
Petersen, Irene
中科院分区：
文献类型：
--
作者：
Wang, Yingying;Hunt, Kate;Petersen, Irene
目的：研究初级保健咨询率的性别差异是否（1）因年龄和贫困状况而异，以及（2）当考虑生殖原因或常见潜在疾病时，咨询率的性别差异是否会减少。设计：对在全科诊所注册的一组患者进行横断面研究。设置：英国初级保健。受试者：2010年登记的446个合格诊所的患者（1 869 149名男性和1 916 898名女性）。主要结局指标：初级保健咨询率。男性的粗略就诊率比女性低32%。性别差异的大小在整个生命过程中各不相同，并没有“多余的”女性咨询在早期和后期的生活。在初级保健咨询方面，16至60岁年龄组的性别差距最大。来自贫困地区的人在咨询方面的性别差异高于来自富裕地区的人。与生育有关的咨询的会计处理减少了，但没有消除性别差距。然而，具有可比基础疾病的男性和女性的就诊率（通过接受药物评估）相似;接受抗抑郁药物治疗的男性咨询的可能性仅比接受抗抑郁药物治疗的女性低8%（相对危险度（RR）0.916，95%CI 0.913至0.918），接受心血管疾病药物治疗的男性仅比男性少5%的可能性咨询。（RR=0.950，95% CI 0.948 - 0.952）。这些小的性别差异进一步减少，特别是抑郁症（RR=0.950，95%CI 0.947至0.953），后也考虑到生殖consultations.Conclusions：咨询的整体性别差异是最显着的年龄在16岁和60岁之间，这些差异只是部分占生殖原因的咨询。在比较男女因类似的潜在疾病接受药物治疗的情况时，男女之间的就诊率差异基本消除。
Objective: To examine whether gender differences in primary care consultation rates (1) vary by age and deprivation status and (2) diminish when consultation for reproductive reasons or common underlying morbidities are accounted for.Design: Cross-sectional study of a cohort of patients registered with general practice.Setting: UK primary care.Subjects: Patients (1 869 149 men and 1 916 898 women) registered with 446 eligible practices in 2010.Primary outcome measures: Primary care consultation rate.Results: This study analyses routinely collected primary care consultation data. The crude consultation rate was 32% lower in men than women. The magnitude of gender difference varied across the life course, and there was no 'excess' female consulting in early and later life. The greatest gender gap in primary care consultations was seen among those aged between 16 and 60 years. Gender differences in consulting were higher in people from more deprived areas than among those from more affluent areas. Accounting for reproductive-related consultations diminished but did not eradicate the gender gap. However, consultation rates in men and women who had comparable underlying morbidities (as assessed by receipt of medication) were similar; men in receipt of antidepressant medication were only 8% less likely to consult than women in receipt of antidepressant medication (relative risk (RR) 0.916, 95% CI 0.913 to 0.918), and men in receipt of medication to treat cardiovascular disease were just 5% less likely to consult (RR=0.950, 95% CI 0.948 to 0.952) than women receiving similar medication. These small gender differences diminished further, particularly for depression (RR=0.950, 95% CI 0.947 to 0.953), after also taking account of reproductive consultations.Conclusions: Overall gender differences in consulting are most marked between the ages of 16 and 60 years; these differences are only partially accounted for by consultations for reproductive reasons. Differences in consultation rates between men and women were largely eradicated when comparing men and women in receipt of medication for similar underlying morbidities.