title: Gender differences in healthcare utilization of patients with diabetes.
abstract: OBJECTIVE
  To examine gender differences in healthcare utilization including outpatient and inpatient medical care for patients with type 2 diabetes mellitus (T2DM), despite participation in T2DM-specific disease management programs (DMP-DM).
  
  
  METHODS
  Baseline data from a cohort study in southwest Germany including 1146 patients with T2DM recruited between October 2008 and March 2010 were used.
  
  
  METHODS
  After bivariate analyses, multivariate Poisson and logistic regression models were used to estimate the effect of sex on the number of general practitioner (GP) and medical specialist appointments, prescribed medications, hospitalizations, and inpatient rehabilitations, with additional consideration of glycemic control levels. Poor glycemic control (PGC) was defined as glycated hemoglobin ≥7.5%.
  
  
  RESULTS
  In total, 905 participants had acceptable glycemic control and 237 participants had poor glycemic control. PGC was more prevalent in men than in women (23% vs 18%). Bivariate analyses among participants with PGC showed significantly fewer GP and medical specialist appointments, a lower number of medications, and longer rehabilitation stays in men than in women. Multivariate regression analyses among participants with PGC confirmed statistically significant gender differences for GP appointments and number of prescribed medications (P <.05) for men compared with women. Gender differences regarding inpatient care were less evident.
  
  
  CONCLUSIONS
  Our data disclosed major gender differences in healthcare utilization of diabetes patients in Germany despite a high DMP-DM rate. Future research should focus attention on gender-specific approaches to healthcare delivery to improve quality and access to care.
authors: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. h.brenner@dkfz.de
authors: Heike U
authors: HU
authors: Krämer
authors: Gernot
authors: G
authors: Rüter
authors: Ben
authors: B
authors: Schöttker
authors: Dietrich
authors: D
authors: Rothenbacher
authors: Thomas
authors: T
authors: Rosemann
authors: Joachim
authors: J
authors: Szecsenyi
authors: Hermann
authors: H
authors: Brenner
authors: Elke
authors: E
authors: Raum
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D005260:Female; D005858:Germany; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012737:Sex Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose