Primary health care use from the perspective of gender and morbidity burden

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.

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.

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.

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.