This study aims to set itself apart from prior research by elucidating gender differences in outpatient service utilization among adults aged 20 years or older, using nationally representative survey data.
Methods:
Data from the Korea Health Panel (KHP) collected between 2010 and 2011 were used. In this study, all KHP participants who accessed outpatient service between 2010 and 2011 were included; 13,525 participants used outpatient services in 2010 and 12,991 in 2011. To analyze factors related to outpatient utilization, regression analysis was performed using generalized estimating equations.
Results:
The use frequency of outpatient service was significantly associated with age, education level, marital status, economic activity, health insurance status, drinking, presence of chronic disease, and self-rated health status in both sexes (p < 0.05). Annual household income significantly affected outpatient utilization only among women.
Conclusions:
Unlike males, females with higher household incomes used outpatient services more. This suggests that females are at greater risk of medical inequality based on economic circumstances.
Get full access to this article
View all access options for this article.
References
1.
VaidyaV, ParthaG, KarmakarM. Gender differences in utilization of preventive care services in the United States. J Womens Health, 2012; 21:140–145.
2.
KraemerHU, RüterG, SchoettkerB, et al.Gender differences in healthcare utilization of patients with diabetes. Am J Manag Care, 2012; 18:362–369.
3.
LeynaertB, SunyerJ, Garcia-EstebanR, et al.Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: A population-based cohort. Thorax, 2012; 67:625–631.
4.
AyonrindeOT, OlynykJK, BeilinLJ, et al.Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease. Hepatology, 2011; 53:800–809.
5.
BolingM, PaduaD, MarshallS, GuskiewiczK, PyneS, BeutlerA. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports, 2010; 20:725–730.
6.
McLeanCP, AsnaaniA, LitzBT, HofmannSG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res, 2011; 45:1027–1035.
7.
CherikhW, YoungC, KramerB, TarantoS, RandallH, FanPY. Ethnic and Gender Related Differences in the Risk of End-Stage Renal Disease After Living Kidney Donation. Am J Transplant, 2011; 11:1650–1655.
8.
MabryR, ReevesM, EakinE, OwenN. Gender differences in prevalence of the metabolic syndrome in Gulf Cooperation Council Countries: A systematic review. Diabet Med, 2010; 27:593–597.
9.
UdoT, GriloCM, McKeeSA. Gender differences in the impact of stressful life events on changes in body mass index. Prev Med, 2014; 69:49–53.
10.
LemogneC, NiedhammerI, KhlatM, et al.Gender differences in the association between depressive mood and mortality: A 12-year follow-up population-based study. J Affect Disord, 2012; 136:267–275.
11.
BackJH, LeeY. Gender differences in the association between socioeconomic status (SES) and depressive symptoms in older adults. Arch Gerontol Geriatr, 2011; 52:e140–e144.
12.
NohJ-W, JoM, HuhT, CheonJ, KwonYD. Gender Differences and Socioeconomic Status in Relation to Overweight among Older Korean People. PLoS One, 2014; 9:e97990.
13.
RichardsonEA, MitchellR. Gender differences in relationships between urban green space and health in the United Kingdom. Soc Sci Med, 2010; 71:568–575.
14.
CherepanovD, PaltaM, FrybackDG, RobertSA. Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: Evidence from four US nationally representative data sets. Qual Life Res, 2010; 19:1115–1124.
15.
PrusSG, GeeE. Gender differences in the influence of economic, lifestyle, and psychosocial factors on later-life health. Can J Public Health, 2003; 94:306–309.
16.
WolinskyFD, MillerTR, AnH, et al.Hospital episodes and physician visits: The concordance between self-reports and medicare claims. Med Care, 2007; 45:300.
17.
HurdleDE. Social support: A critical factor in women's health and health promotion. Health Soc Work, 2001; 26:72–79.
18.
KouzisAC, EatonWW. Absence of social networks, social support and health services utilization. Psychol Med, 1998; 28:1301–1310.
19.
PiniS, PiccinelliM, Zimmermann-TansellaC. Social problems as factors affecting medical consultation: A comparison between general practice attenders and community probands with emotional distress. Psychol Med, 1995; 25:33–41.
20.
Suominen-TaipaleLA, MartelinT, KoskinenS, HolmenJ, JohnsenR. Gender differences in health care use among the elderly population in areas of Norway and Finland. A cross-sectional analysis based on the HUNT study and the FINRISK Senior Survey. BMC Health Serv Res, 2006; 6:1.
21.
MustardCA, KaufertP, KozyrskyjA, MayerT. Sex differences in the use of health care services. N Engl J Med, 1998; 338:1678–1683.
22.
LadwigK-H, Marten-MittagB, FormanekB, DammannG. Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol, 2000; 16:511–518.
23.
DunlopDD, ManheimLM, SongJ, ChangRW. Gender and ethnic/racial disparities in health care utilization among older adults. J Gerontol B Psychol Sci Soc Sci, 2002; 57:S221–S233.
24.
Redondo-SendinoÁ, Guallar-CastillónP, BanegasJR, Rodríguez-ArtalejoF. Gender differences in the utilization of health-care services among the older adult population of Spain. BMC Public Health, 2006; 6:155.
25.
FentonJJ, Von KorffM, LinEH, CiechanowskiP, YoungBA. Quality of preventive care for diabetes: Effects of visit frequency and competing demands. Ann Fam Med, 2006; 4:32–39.
26.
LebowitzBD, PearsonJL, SchneiderLS, et al.Diagnosis and treatment of depression in late life: Consensus statement update. JAMA, 1997; 278:1186–1190.
27.
CrystalS, SambamoorthiU, WalkupJT, AkıncıgilA. Diagnosis and treatment of depression in the elderly medicare population: Predictors, disparities, and trends. J Am Geriatr Soc, 2003; 51:1718–1728.
28.
OjedaVD, McGuireTG. Gender and racial/ethnic differences in use of outpatient mental health and substance use services by depressed adults. Psychiatr Q, 2006; 77:211–222.
29.
BoxGE, CoxDR. An analysis of transformations. J R Stat Soc Series B Stat Methodol, 1964; 26:211–252.
30.
FosterM. What are equivalence scales. OECD Project on Income Distribution and Poverty, 2009. Retrieved from https://www.oecd.org/eco/growth/OECD-Note-EquivalenceScales.pdf Accessed January5, 2016.
31.
HingE, MiddletonK. National Hospital Ambulatory Medical Care Survey: 2002 outpatient department summary. Adv Data, 2004; 345:1–36.
32.
JamesC. Putting Women's Health Care Disparities on the Map: Examining Racial and Ethnic Disparities at the State Level. Kaiser Family Foundation, 2009. Retrieved from http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7886.pdf Accessed January8, 2016.
33.
DentonM, WaltersV. Gender differences in structural and behavioral determinants of health: An analysis of the social production of health. Soc Sci Med, 1999; 48:1221–1235.
34.
White-MeansSI, RubinRM. Is there equity in the home health care market? Understanding racial patterns in the use of formal home health care. J Gerontol B Psychol Sci Soc Sci, 2004; 59:S220–S229.
35.
CarrasquilloO, CarrasquilloAI, SheaS. Health insurance coverage of immigrants living in the United States: Differences by citizenship status and country of origin. Am J Public Health, 2000; 90:917.
36.
OksuzyanA, JuelK, VaupelJW, ChristensenK. Men: Good health and high mortality. Sex differences in health and aging. Aging Clin Exp Res, 2008; 20:91–102.
37.
GaldasPM, CheaterF, MarshallP. Men and health help-seeking behaviour: Literature review. J Adv Nurs, 2005; 49:616–623.
38.
JuelK, ChristensenK. Are men seeking medical advice too late? Contacts to general practitioners and hospital admissions in Denmark 2005. J Public Health (Oxf), 2008; 30:111–113.
39.
BuorD. Gender and the utilisation of health services in the Ashanti Region, Ghana. Health Policy, 2004; 69:375–388.
40.
SambamoorthiU, McAlpineDD. Racial, ethnic, socioeconomic, and access disparities in the use of preventive services among women. Prev Med, 2003; 37:475–484.
41.
BloomSS, WypijD, GuptaMD. Dimensions of women's autonomy and the influence on maternal health care utilization in a north Indian city. Demography, 2001; 38:67–78.
42.
de BoerAG, WijkerW, de HaesHC. Predictors of health care utilization in the chronically ill: A review of the literature. Health Policy, 1997; 42:101–115.
43.
CondeliusA, EdbergA-K, JakobssonU, HallbergIR. Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Arch Gerontol Geriatr, 2008; 46:41–55.
44.
ChuL-W, PeiCK. Risk factors for early emergency hospital readmission in elderly medical patients. Gerontology, 1999; 45:220–226.
45.
KatzSJ, HoferTP, ManningWG. Hospital utilization in Ontario and the United States: The impact of socioeconomic status and health status. Can J Public Health, 1995; 87:253–256.
46.
MorrisS, SuttonM, GravelleH. Inequity and inequality in the use of health care in England: An empirical investigation. Soc Sci Med, 2005; 60:1251–1266.
47.
RegidorE, MartínezD, CalleME, AstasioP, OrtegaP, DomínguezV. Socioeconomic patterns in the use of public and private health services and equity in health care. BMC Health Serv Res, 2008; 8:1.
48.
BorrellC, FernandezE, SchiaffinoA, et al.Social class inequalities in the use of and access to health services in Catalonia, Spain: What is the influence of supplemental private health insurance?. Int J Qual Health Care, 2001; 13:117–125.
49.
BorrellC, RohlfsI, FerrandoJ, PasarínMI, Domínguez-BerjónF, PlasènciaA. Social inequalities in perceived health and the use of health services in a southern European urban area. Int J Health Serv, 1999; 29:743–764.
50.
GwatkinDR, RusteinS, JohnsonK, PandeR, WagstaffA. Initial Country-Level Information about Socio-Economic Differentials in Health, Nutrition and Population, vols. I and II. Washington, DC: World Bank. Health, Population, and Nutrition Division, 2003.
51.
SchneiderAE, DavisRB, PhillipsRS. Discussion of hormone replacement therapy between physicians and their patients. Am J Med Qual, 2000; 15:143–147.
52.
KoganMD, KotelchuckM, AlexanderGR, JohnsonWE. Racial disparities in reported prenatal care advice from health care providers. Am J Public Health, 1994; 84:82–88.
53.
PollakKI, McBrideCM, ScholesD, GrothausLC, CivicD, CurrySJ. Women's reports of smoking cessation advice during reproductive health visits and subsequent smoking cessation. Am J Manag Care, 2002; 8:837–844.
54.
BlazerDG, LandermanLR, FillenbaumG, HornerR. Health services access and use among older adults in North Carolina: Urban vs rural residents. Am J Public Health, 1995; 85:1384–1390.
55.
HossenA, WesthuesA. A socially excluded space: Restrictions on access to health care for older women in rural Bangladesh. Qual Health Res, 2010; 20:1192–1201.
56.
BertakisKD, AzariR, HelmsLJ, CallahanEJ, RobbinsJA. Gender differences in the utilization of health care services. J Fam Pract, 2000; 49:147–152.
57.
BaekYJ, ShinDW, ChoiJY, et al.Late referral to palliative care services in Korea. J Pain Symptom Manage, 2011; 41:692–699.
58.
ShinSM, KimMJ, KimES, LeeHW, ParkCG, KimHK. Medical aid service overuse assessed by case managers in Korea. J Adv Nurs, 2010; 66:2257–2265.
59.
JooK, KimH, LeeS, MinH. A comparative study on medical utilization between urban and rural Korea. Korean J Prev Med, 1996; 29:311–330.
60.
EnsorT, CooperS. Overcoming barriers to health service access: Influencing the demand side. Health Policy Plan, 2004; 19:69–79.
