Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians

Research on patterns of self-rated health and health service use suggests that women report having poorer health than men, and that, after controlling for health measures, women are more likely to obtain formal health care. Proposed reasons for these differences have included that women's self-rated health is more strongly influenced by psychosocial factors or negative affect and that women are likely to obtain services when at better levels of self-rated health, compared with men. Our study explored gender differences in the effects of non-health attributes on decisions to obtain primary medical services for an Australian community-based sample of 4140 adults from two age groups: 40-44 years and 60-64 years. Participants provided information on measures of physical and mental health., and on predisposing and enabling factors that could affect their levels of health service use. Information on visits made to general practitioners (GPs) in a 6-month period was obtained from the national insurer. We found that men and women who obtained no GP services reported comparable levels of physical and mental health and that, for both men and women, measures of health needs were most strongly associated with their obtaining care. After controlling for measures of mental and physical health and enabling factors, we found that non-health factors that could predispose an individual to obtain care had greater impact on men's but not women's decisions to obtain any GP services. Our findings do not support the hypothesis that in choosing to obtain medical care, women are more strongly influenced by non-health factors compared with men. (C) 2004 Elsevier Ltd. All rights reserved.