Socías M Eugenia, Koehoorn Mieke, Shoveller Jean
Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Womens Health Issues. 2016 Jan-Feb;26(1):74-9. doi: 10.1016/j.whi.2015.08.001. Epub 2015 Sep 15.
Existing literature is inconclusive as to whether disparities in access to health care between men and women are mainly driven by socioeconomic or gender inequalities. The aim of this study was to assess whether gender was independently associated with perceived unmet health care needs among a representative sample of British Columbia adults.
Using data from the 2011/2012 Canadian Community Health Survey, logistic regression analyses were conducted to investigate the independent effect of gender on perceived unmet health care needs adjusting for potential individual and contextual confounders.
Among 12,252 British Columbia adults (51.9% female), the prevalence of perceived unmet health care needs was 12.0%, with a significantly greater percentage among women compared with men (13.7% vs. 10.1%; p < .001). After adjusting for multiple confounders, women had independently increased odds of perceived unmet health care needs (adjusted odds ratio, 1.37; 95% CI, 1.11-1.68).
The current study found that, among a representative sample of British Columbia adults and adjusting for various individual and contextual factors, female gender was associated independently with an increased odds of perceived unmet health care needs.
These findings suggest that within Canada's universal health system, gender further explains differences in health care access, over and above socioeconomic inequalities. Interventions within and outside the health sector are required to achieve equitable access to health care for all residents in British Columbia.
关于男女在获得医疗保健方面的差异主要是由社会经济不平等还是性别不平等所驱动,现有文献尚无定论。本研究的目的是评估在不列颠哥伦比亚省成年人的代表性样本中,性别是否与感知到的未满足的医疗保健需求独立相关。
利用2011/2012年加拿大社区健康调查的数据,进行逻辑回归分析,以研究性别对感知到的未满足的医疗保健需求的独立影响,并对潜在的个体和背景混杂因素进行调整。
在12252名不列颠哥伦比亚省成年人中(51.9%为女性),感知到的未满足的医疗保健需求的患病率为12.0%,女性的比例显著高于男性(13.7%对10.1%;p<.001)。在调整了多个混杂因素后,女性感知到的未满足的医疗保健需求的独立几率增加(调整后的优势比为1.37;95%可信区间为1.11-1.68)。
本研究发现,在不列颠哥伦比亚省成年人的代表性样本中,并在调整了各种个体和背景因素后,女性性别与感知到的未满足的医疗保健需求的几率增加独立相关。
这些发现表明,在加拿大的全民医疗体系中,除了社会经济不平等之外,性别进一步解释了医疗保健获取方面的差异。需要在卫生部门内外采取干预措施,以实现不列颠哥伦比亚省所有居民公平获得医疗保健的目标。