title: Sex differences in health care consumption in Sweden: A register-based cross-sectional study.
abstract: BACKGROUND
  Generally, health care consumption, especially primary care, is greater among women than men. The extent to which this sex difference is explained by reproduction and sex-specific morbidity is unclear.
  
  
  METHODS
  We examined age- and sex-specific health care service utilization and costs in the western region of Sweden. Data were retrieved from a regional health care database of information on total health care consumption in the population. Use of health care resources was divided into the following diagnosis categories: health care associated with reproduction; health care received for sex-specific morbidity; and health care provided for all other conditions.
  
  
  RESULTS
  Total per capita cost for health care was 20% higher for women than for men. When adjusted for reproduction and sex-specific morbidity, the cost-difference decreased to 8%. The remaining cost-difference could be explained by women's substantially higher costs for mental and behavioral disorders and diseases of the musculoskeletal system. Women were more likely to receive more accessible, less expensive primary care, while men were more likely to receive specialist inpatient care.
  
  
  CONCLUSIONS
  The substantially greater use of reproduction-associated care among women, which largely occurs within primary care, might make it easier to also seek health care for other reasons. Efforts to eliminate barriers that prevent men from investing in their health and seeking primary care could reduce future morbidity and costs for specialist care. More studies and appropriate actions are needed to determine why women are overrepresented in mental, behavioral and musculoskeletal disorders.
authors.affiliation: Institute of Medicine, Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine, Sahlgrenska Academy, Gothenburg University, Sweden Centre for Equity in Health, Region Västra Götaland, Sweden ingrid.osika@socmed.gu.se.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Osika Friberg
authors.affiliation: Institute of Medicine, Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine, Sahlgrenska Academy, Gothenburg University, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Krantz
authors.affiliation: Department of Systems Development and Strategy, Region Västra Götaland, Sweden.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Määttä
authors.affiliation: Institute of Medicine, Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine, Sahlgrenska Academy, Gothenburg University, Sweden Department of Systems Development and Strategy, Region Västra Götaland, Sweden.
authors.forename: Krister
authors.initials: K
authors.lastname: Järbrink
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D012042:Registries; D012737:Sex Factors; D013548:Sweden; D055815:Young Adult
keywords: Sex differences; contacts; costs; gender; health economics; primary care; reproduction; sex-specific; specialist care