Santosh Jatrana, Crampton Peter
Department of Public Health, School of Medicine and Health Sciences, University of Otago, Wellington PO Box 7343, Wellington, New Zealand.
J Prim Health Care. 2009 Dec;1(4):261-9.
This paper aims to examine gender differences in general practice utilisation in New Zealand.
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.
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).
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.
本文旨在研究新西兰全科医疗服务利用方面的性别差异。
本研究数据来自参与2001/2002年全国初级医疗保健调查(NatMedCa)的246名全科医生(GP)收集的10506份就诊记录,该调查是一项具有全国代表性的、多阶段的、概率抽样调查,涉及全科医生和患者就诊情况。过去12个月内至少就诊过一次全科医生的患者中,过去12个月内到全科医疗服务机构就诊的次数作为结果变量。采用泊松回归进行分析。
在过去12个月中,女性比男性更有可能去看全科医生(发病率比=1.13;95%置信区间:1.03-1.24)。我们还发现,即使排除妇产科疾病且涵盖所有年龄组,女性在全科医生服务利用方面仍存在显著过量。亚洲女性比欧洲女性看全科医生的可能性低39%(发病率比=0.61;95%置信区间:0.43-0.85);这一结果在男性对全科医生服务的利用中未体现。此外,我们发现,与“自限性”问题相比,看全科医生的女性报告“危及生命”问题的可能性高39%(发病率比=1.39;95%置信区间:1.00-1.94)。
我们的研究结果不支持以下文献观点,即女性服务利用过量在很大程度上可归因于妇产科疾病,或女性就诊过量集中在生育年龄。种族和问题的严重程度对解释女性而非男性对全科医生的利用有显著作用。