Women's Health

Women use more health care services than men, and their health care costs more

Women tend to use more primary care services and to have higher overall medical charges than men. However, they have similar hospitalization rates and costs as men, according to a study supported by the Agency for Healthcare Research and Quality (HS06167). At the beginning of this study, women reported significantly lower mental and physical health status than men. Thus, it is not surprising that they had a significantly higher mean number of primary care visits (4 vs. 3) and diagnostic services (10 vs. 7) over the course of a year than men.

Primary care physicians may be more likely to order laboratory, radiologic, and other diagnostic tests for women who make more frequent visits and have continuing complaints, explains principal investigator, Klea D. Bertakis, M.D., M.P.H. Dr. Bertakis and her colleagues from the University of California, Davis, randomly assigned 509 new adult patients to primary care physicians at a university medical center. They interviewed the patients to collect sociodemographic data and used a questionnaire to assess patients' self-reported health status; the process was repeated a year later.

The researchers found that women had about the same mean number of specialty clinic visits as men (2.8 vs. 2.3), emergency department visits (0.31 vs. 0.25), and hospitalizations (0.17 vs. 0.19). They did not find higher referral rates for specialty care for men that have been found by other researchers.

On the other hand, women had higher annual charges than men for primary care, specialty care, emergency treatment, and diagnostic services, as well as total annual charges, after adjustments for health status, sociodemographic factors, and clinic assignment. The higher charges for specialty care and emergency treatment for women, despite similar visit rates as men, may be due to the poor health status of women, which in turn may have led to more complicated and costlier care when they were seen, suggests Dr. Bertakis.

This is the first study of its kind to control for patient health status (using the Medical Outcomes Study Short Form-36) and sociodemographic variables in addition to physician specialty.

More details are in "Gender differences in the utilization of health care services," by Dr. Bertakis, Rahman Azari, Ph.D., Jay Helms, Ph.D., and others, in the February 2000 Journal of Family Practice 49(2), pp. 147-152.

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