title: Gender differences in symptoms and care delivery for chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Morbidity and mortality for women with chronic obstructive pulmonary disease (COPD) are increasing, and little is known about gender differences in perception of COPD care.
  
  
  METHODS
  Surveys were administered to a convenience sample of COPD patients to evaluate perceptions about symptoms, barriers to care, and sources of information about COPD.
  
  
  RESULTS
  Data on 295 female and 273 male participants were analyzed. With similar frequencies, women and men reported dyspnea and rated their health as poor/very poor. Although more women than men reported annual household income <$30,000, no significant gender differences in frequency of health insurance, physician visits, or ever having had spirometry were detected. In adjusted models (1) women were more likely to report COPD diagnostic delay (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.13-2.45, p=0.01), although anxiety (OR 1.83, 95% CI 1.10-3.06, p=0.02) and history of exacerbations (OR 1.60, 95% CI 1.08-2.37, p=0.01) were also significant predictors, (2) female gender was associated with difficulty reaching one's physician (OR 2.54, 95% CI 1.33-4.86, p=0.004), as was prior history of exacerbations (OR 2.25, 95% CI 1.21-4.20, p=0.01), and (3) female gender (OR 2.15, 95% CI 1.10-4.21, p=0.02) was the only significant predictor for finding time spent with their physician as insufficient.
  
  
  CONCLUSIONS
  Significant gender-related differences in the perception of COPD healthcare delivery exist, revealing an opportunity to better understand what influences these attitudes and to improve care for both men and women.
authors.affiliation: University of Michigan Health System, Ann Arbor, Michigan 48109-5360, USA. carlosma@umich.edu
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Martinez
authors.forename: Swetha
authors.initials: S
authors.lastname: Raparla
authors.forename: Craig A
authors.initials: CA
authors.lastname: Plauschinat
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Giardino
authors.forename: Barbara
authors.initials: B
authors.lastname: Rogers
authors.forename: Julien
authors.initials: J
authors.lastname: Beresford
authors.forename: Judith D
authors.initials: JD
authors.lastname: Bentkover
authors.forename: Amy
authors.initials: A
authors.lastname: Schachtner-Appel
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Curtis
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Martinez
authors.forename: MeiLan K
authors.initials: MK
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D057210:Delayed Diagnosis; D003695:Delivery of Health Care; D005260:Female; D005783:Gender Identity; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006304:Health Status; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D010465:Perception; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D013147:Spirometry; D011795:Surveys and Questionnaires
chemical_list: D001993:Bronchodilator Agents