Literature Review on Effective Sex- and Gender-Based Systems/Models of Care

The U.S. Department of Health and Human Services, Office on Women's Health (OWH), commissioned this literature review to provide an up-to-date review of effective sex- and gender-based systems/models of healthcare. The review investigated seven main research questions:

1. What key sex and gender differences exist in the current healthcare system structure, including reimbursement mechanisms, content of and access to appropriate care, quality of care, and patient safety?
2. What models or approaches have been successful in engaging and retaining people in systems of healthcare, especially the underserved, the "difficult to reach," or low literacy populations? Are there sex/gender differences in the effectiveness of these approaches?
3. What are the trends in demographics, service delivery, costs, insurance, or other sectors that could be addressed via a systems approach? To what extent are patients reimbursed for care for specific services (i.e., prevention, mental health, etc.)? Are there gender or sex differences in out-of-pocket patient costs?
4. How does a service delivery site successfully integrate a model program into its current infrastructure of delivering care?
5. How effective are sex- and gender-based healthcare practices? What measures have been used to determine the effectiveness of these practices? What barriers exist to translating/adapting these approaches into clinical practice?
6. How effective is a focus on clinical care at improving women's healthcare? How effective are systemic improvements (i.e. more women in professorships/research positions or emphasis on women's health in medical school curriculum) at improving women's healthcare? Are there other factors (e.g. continuity of care) that may be more important to women than to men or to women's outcomes vs. men's outcomes?
7. How can programs targeting boys and men be created to recruit and retain them in the healthcare system? Are programs such as patient advocate or patient navigator more needed or more effective for men at getting them into the system and to needed care?

The literature search was conducted in October and November of 2006. Relevant materials were identified via electronic searches of 12 wide-ranging academic databases that catalog thousands of academic journals, individual journal searches, a library catalog search for relevant books, personal contacts with experts in this field, and an Internet search.

Language: English
Format: HTML and PDF (1 MB)
Date: January 2007

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• Literature Review on Effective Sex- and Gender-Based Systems/Models of Care