Hippisley-Cox Julia, Yates Janet, Pringle Mike, Coupland Carol, Hammersley Vicky
Division of Primary Care, University of Nottingham, Nottingham.
Br J Gen Pract. 2006 May;56(526):342-8.
Health experiences differ between men and women. The health services have focused their attention on gynaecological health problems in women, however women with non-gynaecological health problems could be unintentionally neglected. Given the increased prevalence of diabetes, the healthcare needs and experiences of women with diabetes are increasing.
To determine the extent of sex inequalities in access to care for diabetes in primary care.
Cross-sectional population-based questionnaire study.
Twenty-three general practices spread through 23 different primary care trusts in the former Trent Region, UK.
The study consisted of a random sample of 1,673 patients with diabetes. Outcomes measured were odds ratios adjusted for age for measures of physical access to the GP's surgery; ease of obtaining appointments; access to primary care professionals; levels of routine diabetes care received; barriers to physical activity, problems eating and psychological distress as measured by the 18 score Diabetes Health Profile.
Women were less likely than men to report that they had talked to their GP or practice nurse about their diabetes in the previous 12 months and were less likely to report that they were able to book routine appointments at convenient times. Almost 40% of all patients with diabetes reported difficulty in visiting the GP's surgery for their diabetes care, and women were more likely to report difficulties in visiting the surgery than men. Women were more likely than men to be afraid to go out alone (7.9% versus 3.6%) and more likely to be housebound (6.8% versus 2.4%). Women had significantly higher scores for eating problems and barriers to physical activity than men.
Women report more problems with access to diabetes care than men. If the ambitions of the National Service Framework are to be met, then positive action needs to be taken to improve access to care for women with diabetes.
男性和女性的健康经历有所不同。医疗服务将注意力集中在女性的妇科健康问题上，然而患有非妇科健康问题的女性可能会被无意地忽视。鉴于糖尿病患病率的上升，糖尿病女性患者的医疗需求和经历也在增加。
确定初级保健中糖尿病护理可及性方面的性别不平等程度。
基于人群的横断面问卷调查研究。
分布在英国前特伦特地区23个不同初级保健信托机构的23家全科诊所。
该研究包括对1673名糖尿病患者的随机抽样。测量的结果是针对到全科医生诊所就诊的实际可及性、预约的难易程度、接触初级保健专业人员的机会、接受的常规糖尿病护理水平；通过18项得分的糖尿病健康概况测量的身体活动障碍、饮食问题和心理困扰。
女性比男性更不太可能报告在过去12个月里与全科医生或执业护士谈论过自己的糖尿病，也更不太可能报告能够在方便的时间预约常规就诊。几乎40%的糖尿病患者报告在前往全科医生诊所进行糖尿病护理时存在困难，女性比男性更有可能报告前往诊所存在困难。女性比男性更有可能害怕独自外出（7.9%对3.6%），也更有可能足不出户（6.8%对2.4%）。女性在饮食问题和身体活动障碍方面的得分显著高于男性。
女性报告在糖尿病护理可及性方面比男性存在更多问题。如果要实现国家服务框架的目标，就需要采取积极行动来改善糖尿病女性患者的护理可及性。
