MRC|CSO Social & Public Health Science Unit, University of Glasgow, Glasgow, UK.
BMJ Open. 2013 Aug 19;3(8):e003320. doi: 10.1136/bmjopen-2013-003320.
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.
Cross-sectional study of a cohort of patients registered with general practice.
UK primary care.
Patients (1 869 149 men and 1 916 898 women) registered with 446 eligible practices in 2010.
Primary care consultation rate.
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.
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.
探讨初级保健就诊率的性别差异(1)是否因年龄和贫困状况而异,以及(2)当考虑到因生殖原因或常见潜在疾病就诊时,这种差异是否会减少。
对注册普通科医生的患者队列进行的横断面研究。
英国初级保健。
2010 年在 446 家符合条件的诊所注册的患者(1869149 名男性和 1916898 名女性)。
初级保健就诊率。
本研究分析了常规收集的初级保健就诊数据。男性的就诊率比女性低 32%。性别差异的幅度在整个生命周期中有所不同,在早期和晚期生活中并没有“过度”的女性就诊。在 16 至 60 岁的人群中,初级保健就诊的性别差距最大。在贫困程度较高的人群中,性别差异的咨询率高于贫困程度较低的人群。考虑到与生殖相关的咨询,性别差距有所缩小,但并未消除。然而,在接受类似药物治疗的男性和女性患者中,就诊率相似;服用抗抑郁药的男性就诊的可能性比服用抗抑郁药的女性低 8%(相对风险(RR)0.916,95%置信区间 0.913 至 0.918),而服用心血管疾病药物的男性就诊的可能性比服用类似药物的女性低 5%(RR=0.950,95%置信区间 0.948 至 0.952)。这些较小的性别差异进一步缩小,特别是在考虑到生殖咨询后,对抑郁症的差异(RR=0.950,95%置信区间 0.947 至 0.953)。
在 16 至 60 岁之间,咨询的总体性别差异最为明显;这些差异仅部分归因于生殖原因的咨询。当比较接受类似潜在疾病药物治疗的男性和女性时,男性和女性之间的就诊率差异基本消除。