title: [Referrals and sex of physicians and patients: a gender analysis, Andalussia, Spain].
abstract: BACKGROUND
  It has been identified differences of medical care practice in primary care related to physician's sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provision of health services.
  
  
  OBJECTIVE
  To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction between patient's sex and physician's sex.
  
  
  METHODS
  Observational, cross-sectional, and multicenter study.
  
  
  METHODS
  4 health districts in Andalucía and their physicians.
  
  
  METHODS
  382 physicians.
  
  
  METHODS
  referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation.
  
  
  METHODS
  databases of health districts.
  
  
  METHODS
  2010.
  
  
  METHODS
  Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model.
  
  
  RESULTS
  In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians.
  
  
  CONCLUSIONS
  There are no differences in referral according to physician's sex. However, there are signs that might indicate the existence of gender inequality, and women patient received less referrals. There are no physician-patient's sex interaction.
authors.forename: Ana
authors.initials: A
authors.lastname: Delgado
authors.forename: Lorena
authors.initials: L
authors.lastname: Saletti-Cuesta
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez-Cantalejo
authors.forename: Begoña
authors.initials: B
authors.lastname: López-Hernández
authors.forename: Pilar
authors.initials: P
authors.lastname: Guijosa-Campos
authors.forename: Margarita
authors.initials: M
authors.lastname: Acosta-Ferrer
authors.forename: Juana
authors.initials: J
authors.lastname: Montoya-Vergel
authors.forename: Natalia
authors.initials: N
authors.lastname: Gil-Garrido
mesh_terms: D000328:Adult; D003151:Community Health Centers / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012737:Sex Factors; D013030:Spain; D055815:Young Adult