[Quality assurance in physiotherapeutic management: a gender-based analysis of health insurance data].
OBJECTIVE
Studies on the gender equivalence of health-care reveal differences in the handling of men and women that cannot be justified medically. This contribution analyses, for the example of physiotherapeutic management, whether a gender bias, as found for other medical fields, also exists in the provision of remedial interventions.


METHODS
On the basis of the prescription data from a health insurance company (Gmünder Ersatzkasse, GEK), a gender-differential analysis of physiotherapy was undertaken. Prescription data for medications in the year 2005 were evaluated, differentiated according to the type of prescribed treatment, the age and gender of the insured person and the prescribing specialist group. Random samples were taken from the medicament prescriptions for further analyses.


RESULTS
The analysis of prescription data revealed that, of the 1.6 million insured persons, 16.1% of the women (absolute: 119,354) and 11.7%of the men (absolute: 101,002) received at least one prescription for physiotherapy, the average age of all the insured persons receiving prescriptions for physiotherapeutic measures was 46 years for both sexes. Differential evaluation showed that women received a follow-on prescription slightly more frequently and that the number of treatment units per prescription was higher. Differences were also seen in the forms of the prescribed treatments. The data reveal a gender bias in physiotherapeutic management that can be explained by a differing compliance behaviour of the patient and prescribing behaviour of the physician.


CONCLUSIONS
Accordingly, quality deficits also occur in the field of remedial interventions as a result of a gender bias, as has also been documented in other fields of medical management, especially with regard to the provision of medicaments.
Kemper
C
C
Zentrum für Sozialpolitik, Universität Bremen. ckemper@zes.uni-bremen.de
Deitermann
B
B
Kuhlmann
E
E
Glaeske
G
G
D000328:Adult; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D011287:Prejudice; D055656:Prescriptions / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D017678:Sex Distribution