Do Men Avoid Seeking Medical Advice? Gender-Specific Changes in Primary Healthcare Use after First Hospitalization at Ages 60+ in Denmark.

Andreas Höhn , University of St. Andrews
Jutta Gampe, Max Planck Institute for Demographic Research
Rune Lindahl-Jacobsen, Max Planck Odense Center on the Biodemography of Aging
Kaare Christensen, University of Southern Denmark and Odense University Hospital
Anna Oksuzyan, Bielefeld University

It remains unclear whether women’s greater primary healthcare use reflects a lower threshold for treatment-seeking or a health disadvantage. We address this question by studying primary healthcare use surrounding a major health shock.This cohort study utilizes routinely-collected healthcare data covering the total Danish population aged 60+ between 1996 and 2011. Using a hurdle model, we investigated levels of primary healthcare use and levels of non-use before and after the first inpatient hospital admission for stroke, myocardial infarction (MI), chronic obstructive pulmonary disease (COPD), and gastrointestinal cancers (GIC). Before hospitalization, men were more likely to be non-users [Odds Ratios (ORs) & 95% Confidence Interval (CI); Stroke: 1.802 (1.731-1.872); MI: 1.841 (1.760-1.922); COPD: 2.160 (2.028-2.292); GIC: 1.609 (1.525-1.693)], and had fewer contacts when they were users [Proportional Change (eß) & 95% CI; Stroke: 0.821 (0.806-0.836); MI: 0.796 (0.778-0.814); COPD: 0.855 (0.832-0.878); GIC: 0.859 (0.838-0.881)]. Levels of non-use dropped more sharply among men [ORs & 95% CI; Stroke: 0.965 (0.879-1.052); MI: 0.894 (0.789-0.999); COPD: 0.755 (0.609-0.900); GIC: 0.895 (0.801-0.988)], and increases in the level of healthcare use were more pronounced among men users [eß & 95% CI; Stroke: 1.113 (1.102-1.124); MI: 1.112 (1.099-1.124); COPD: 1.078 (1.063-1.093); GIC: 1.097 (1.079-1.114)]. Gender differences became generally more apparent after controlling for survival following hospitalization. Women’s consistently higher levels of primary healthcare use are likely to be explained by a combination of both: a lower threshold for seeking medical advice, and a health disadvantage resulting from better survival in bad health.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality