D'Arcy C, Schmitz J A
Can J Psychiatry. 1979 Feb;24(1):19-27. doi: 10.1177/070674377902400106.
Comprehensive data on all pscyhiatric patients in Saskatchewan show that women are substantially higher users of health services for psychiatric problems than are men. Women: 1) use up to twice as many services as men in the private sector, but use almost the same number of public sector services; 2) tend to be treated for psychosomatic and neurotic disorders on an outpatient basis; 3) have only a slightly greater chance than men of being hospitalized; and 4) are less likely than men to have organic or addictive diagnoses. These differentials in utilization cannot be explained by age, diagnoses and/or marital status. Sex is the best predictor of utilization. These results are largely consistent with utilization and epidemiological literature. It seems more likely that these sex differences in utilization result from the interaction of biology, sex roles, and the functioning and labelling processes of the health system rather than from any single factor. Combining Andersen's components of health behaviour with Freidson's lay-professional construction of illness continuum yields a possible framework for understanding sex differences in the utilization of psychiatric health services.
萨斯喀彻温省所有精神科患者的综合数据显示,女性因精神问题使用医疗服务的频率大幅高于男性。女性:1)在私营部门使用的服务数量是男性的两倍,但在公共部门使用的服务数量几乎相同;2)倾向于在门诊治疗身心疾病和神经症;3)住院的可能性仅略高于男性;4)被诊断患有器质性疾病或成瘾性疾病的可能性低于男性。这些使用差异无法用年龄、诊断和/或婚姻状况来解释。性别是使用情况的最佳预测指标。这些结果在很大程度上与使用情况和流行病学文献一致。使用方面的这些性别差异似乎更有可能是生物学、性别角色以及卫生系统的运作和标签过程相互作用的结果,而不是任何单一因素造成的。将安德森的健康行为要素与弗里德森的医患对疾病连续体的构建相结合,可能会产生一个理解精神科医疗服务使用中性别差异的框架。