Gender differences in financial barriers to primary health care in New Zealand.
BACKGROUND
Gender differences in health status and use of health care services have been established in the developed world with less attention paid to gender differences in financial barriers to primary care. Such barriers represent potentially avoidable mortality and morbidity.


OBJECTIVE
To examine gender differences in financial barriers to New Zealand primary health care.


METHODS
Data from SoFIE-health, an add-on to Statistics New Zealand-led Survey of Family, Income and Employment (SoFIE), analysed using logistic regression, controlling for demographic, socioeconomic, health behaviour and health variables. Access to primary health care includes general practitioner and dental care and prescription drugs.


RESULTS
Odds of deferring seeing their doctor(s), dentist and buying a prescription respectively at least once during preceding 12 months, because they could not afford the cost of a visit or prescription, were greater for women compared to men (Odds Ratio (OR) 1.82, 95% CI: 1.67-1.99; OR 2.05, 95% CI: 1.78-2.34; and OR 1.58, 95% CI: 1.47-1.71; respectively). Adjusting for demographic, socioeconomic, health behaviour and health status attenuated OR to 1.45 (1.31-1.61) for deferring medical visit, 1.47 (1.26-1.71) buying prescription, and 1.35 (1.24-1.46) for deferring dental visit, although confidence intervals still excluded the null.


CONCLUSIONS
Gender significantly associated with reporting cost barriers to primary health care, regardless of individual deprivation or income levels, suggesting that primary health care policies targeting gender-specific factors are warranted. Policy measures to reduce co-payments may improve access to care for both women and men, and may have positive health implications.
Alfred Deakin Research Institute, Deakin University, Geelong Geelong, Victoria 3220, Australia. santosh.jatrana@deakin.edu.au
Santosh
S
Jatrana
Peter
P
Crampton
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003729:Dental Care / Q000191:economics; D005260:Female; D058006:General Practice / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics; D006302:Health Services Research; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D055553:Prescription Drugs / Q000191:economics; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult
D055553:Prescription Drugs