Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort
Objective: This study aims to describe the determinants related to gender differences in the GP utilization in Danish population aged 50–65 years. Design: Cohort-based cross-sectional study. Setting: Danish general practice. Subjects: Totally, 54,849 participants of the Danish Diet, Cancer and Healt...
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doaj-c014dc6379d3412f8417a0944105c8ba2020-11-24T23:27:17ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242016-07-0134324024910.1080/02813432.2016.12071411207141Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health CohortJeanette Therming Jørgensen0John Sahl Andersen1Anne Tjønneland2Zorana Jovanovic Andersen3University of CopenhagenUniversity of CopenhagenDanish Cancer SocietyUniversity of CopenhagenObjective: This study aims to describe the determinants related to gender differences in the GP utilization in Danish population aged 50–65 years. Design: Cohort-based cross-sectional study. Setting: Danish general practice. Subjects: Totally, 54,849 participants of the Danish Diet, Cancer and Health cohort (50–65 years). Main outcome measures: The sum of cohort members’ face-to-face consultations with general practitioner (GP) at the cohort baseline year (1993–1997). We obtained data on GP visits from the Danish National Health Service Register at the cohort baseline (1993–1997), when information on lifestyle (smoking, body mass index (BMI), alcohol use, physical activity), medical conditions (somatic and mental), employment, education, gravidity, and hormone therapy (HT) use was collected by questionnaire. Results: Women had on average 4.1 and men 2.8 consultations per year. In a crude model, women had 47% higher rate of GP visits than men (incidence rate ratio: 1.47; 95% Confidence Interval: 1.45–1.50), which remained unchanged after adjustment for lifestyle, socio-demographic and medical factors, but attenuated to 18% (1.18; 1.13–1.24) after adjustment for female factors (gravidity and post-menopausal HT. In a fully adjusted model, subjects with hypertension (1.63; 1.59–1.67), mental illness (1.63; 1.61–1.66), diabetes (1.56; 1.47–1.65), angina pectoris (1.28; 1.21–1.34), and unemployed persons (1.19; 1.18–1.21) had highest rates of GP visits. Conclusions: Gravidity and HT use explain a large proportion, but not all of the gender difference in GP utilization. Medical conditions (somatic and mental) and unemployment are the main determinants of GP utilization in men and women, while lifestyle has minor effect.Key points Female gender remained a dominant determinant of GP utilization, after adjustment for lifestyle, socio-demography, medical and gender specific factors, with females consulting their GP 18% more often than males. Female reproductive factors (use of postmenopausal hormone therapy and gravidity) explained a large proportion of the gender variation in use of GP. Strongest determinants for GP use among Danish adults aged 50–65 years were the presence of medical conditions (somatic and mental) and unemployment, while lifestyle factors (e.g., body mass index, alcohol consumption and smoking) had minor effect.http://dx.doi.org/10.1080/02813432.2016.1207141CohortDenmarkgendergeneral practicehealth service use lifestyleunemployment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jeanette Therming Jørgensen John Sahl Andersen Anne Tjønneland Zorana Jovanovic Andersen |
spellingShingle |
Jeanette Therming Jørgensen John Sahl Andersen Anne Tjønneland Zorana Jovanovic Andersen Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort Scandinavian Journal of Primary Health Care Cohort Denmark gender general practice health service use lifestyle unemployment |
author_facet |
Jeanette Therming Jørgensen John Sahl Andersen Anne Tjønneland Zorana Jovanovic Andersen |
author_sort |
Jeanette Therming Jørgensen |
title |
Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort |
title_short |
Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort |
title_full |
Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort |
title_fullStr |
Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort |
title_full_unstemmed |
Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort |
title_sort |
determinants related to gender differences in general practice utilization: danish diet, cancer and health cohort |
publisher |
Taylor & Francis Group |
series |
Scandinavian Journal of Primary Health Care |
issn |
0281-3432 1502-7724 |
publishDate |
2016-07-01 |
description |
Objective: This study aims to describe the determinants related to gender differences in the GP utilization in Danish population aged 50–65 years. Design: Cohort-based cross-sectional study. Setting: Danish general practice. Subjects: Totally, 54,849 participants of the Danish Diet, Cancer and Health cohort (50–65 years). Main outcome measures: The sum of cohort members’ face-to-face consultations with general practitioner (GP) at the cohort baseline year (1993–1997). We obtained data on GP visits from the Danish National Health Service Register at the cohort baseline (1993–1997), when information on lifestyle (smoking, body mass index (BMI), alcohol use, physical activity), medical conditions (somatic and mental), employment, education, gravidity, and hormone therapy (HT) use was collected by questionnaire. Results: Women had on average 4.1 and men 2.8 consultations per year. In a crude model, women had 47% higher rate of GP visits than men (incidence rate ratio: 1.47; 95% Confidence Interval: 1.45–1.50), which remained unchanged after adjustment for lifestyle, socio-demographic and medical factors, but attenuated to 18% (1.18; 1.13–1.24) after adjustment for female factors (gravidity and post-menopausal HT. In a fully adjusted model, subjects with hypertension (1.63; 1.59–1.67), mental illness (1.63; 1.61–1.66), diabetes (1.56; 1.47–1.65), angina pectoris (1.28; 1.21–1.34), and unemployed persons (1.19; 1.18–1.21) had highest rates of GP visits. Conclusions: Gravidity and HT use explain a large proportion, but not all of the gender difference in GP utilization. Medical conditions (somatic and mental) and unemployment are the main determinants of GP utilization in men and women, while lifestyle has minor effect.Key points Female gender remained a dominant determinant of GP utilization, after adjustment for lifestyle, socio-demography, medical and gender specific factors, with females consulting their GP 18% more often than males. Female reproductive factors (use of postmenopausal hormone therapy and gravidity) explained a large proportion of the gender variation in use of GP. Strongest determinants for GP use among Danish adults aged 50–65 years were the presence of medical conditions (somatic and mental) and unemployment, while lifestyle factors (e.g., body mass index, alcohol consumption and smoking) had minor effect. |
topic |
Cohort Denmark gender general practice health service use lifestyle unemployment |
url |
http://dx.doi.org/10.1080/02813432.2016.1207141 |
work_keys_str_mv |
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