Gender disparities in health and healthcare use among older adults.
BACKGROUND
Gender differences in health and the use of health services are a long-standing concern for the U.S. medical system. Our purpose was to examine if there are patterns of gender differences in the type of medical service used among older Americans.


METHODS
We conducted a prospective study of 9164 Americans aged >or=65 followed through the Health and Retirement Study (HRS), a national probability sample of community dwelling adults. Self-reported medical utilization between 2002 and 2004 was modeled as a function of 2002 baseline characteristics of the sample.


RESULTS
Health needs were substantially greater among older women compared with men, but women had fewer economic resources. Controlling for health needs did little to explain gender differences in preventive care and increased gender differences in the use of hospital services. Women were less likely to have hospital stays (adjusted odds ratio [OR] = 0.79) and had fewer physician visits (3.07 vs. 3.30 median visits within 2 years) than men with similar demographic and health profiles. In contrast, the greater use of home healthcare among women was almost entirely explained by their greater health needs.


CONCLUSIONS
These national data show that simple evaluations of age-adjusted gender differences in the use of hospital and physician services that do not account for underlying health needs are in danger of understating these disparities.
Cameron
Kenzie A
KA
Department of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. k-cameron@northwestern.edu
Song
Jing
J
Manheim
Larry M
LM
Dunlop
Dorothy D
DD
D000368:Aged; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012737:Sex Factors; D014481:United States