title: Primary health care use from the perspective of gender and morbidity burden.
abstract: BACKGROUND
  Sex and gender can interact to contribute to differences in morbidity and mortality between men and women. To detect such differences is an important issue for health policy planners when designing programmes for the provision of healthcare services for the whole population. Our aim was to study differences between men and women in the use of Primary Health Care (PHC) resources, taking into account age and morbidity burden.
  
  
  METHODS
  An observational retrospective study was carried out using the information gathered in electronic medical records from 79,809 adult patients who attended a PHC centre at least once in 2008. The ACG® System was used to quantify the morbidity burden of patients. Poisson regression models were applied to analyse differences in the number of visits to the PHC centre by men and women.
  
  
  RESULTS
  Morbidity burden was significantly higher in women of all age groups. The gross number of visits to the PHC centre was also higher for women in all age groups. However, when adjusting by age and morbidity burden, we did not find a higher utilization by women compared to men. For high levels of morbidity burden, the attendance by men was even significantly higher.
  
  
  CONCLUSIONS
  The overall higher use of PHC by women seems to be associated with their higher morbidity burden. The interaction between biology and socially constructed roles could also underlie this higher use by women, and is therefore an area that deserves further in-depth research.
authors.affiliation: University of Zaragoza, Zaragoza, Spain. mtcarret@unizar.es.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Carretero
authors.affiliation: University of Zaragoza, Zaragoza, Spain. acalderon.iacs@aragon.es.|EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain. acalderon.iacs@aragon.es.|Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain. acalderon.iacs@aragon.es.|Grupo de Investigación en Servicios Sanitarios (GRISSA), Aragón Health Sciences Institute (IACS), IIS Aragón, Zaragoza, Spain. acalderon.iacs@aragon.es.
authors.forename: Amaia
authors.initials: A
authors.lastname: Calderón-Larrañaga
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain. bpoblador.iacs@aragon.es.|Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain. bpoblador.iacs@aragon.es.|Grupo de Investigación en Servicios Sanitarios (GRISSA), Aragón Health Sciences Institute (IACS), IIS Aragón, Zaragoza, Spain. bpoblador.iacs@aragon.es.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Poblador-Plou
authors.affiliation: University of Zaragoza, Zaragoza, Spain. sprados.iacs@aragon.es.|EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain. sprados.iacs@aragon.es.|Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain. sprados.iacs@aragon.es.|Grupo de Investigación en Servicios Sanitarios (GRISSA), Aragón Health Sciences Institute (IACS), IIS Aragón, Zaragoza, Spain. sprados.iacs@aragon.es.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Prados-Torres
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D057286:Electronic Health Records; D005260:Female; D006285:Health Planning; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009819:Office Visits / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D013030:Spain; D055815:Young Adult