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dc.contributor.authorHöhn, Andreas
dc.contributor.authorGampe, Jutta
dc.contributor.authorLindahl-Jacobsen, Rune
dc.contributor.authorChristensen, Kaare
dc.contributor.authorOksuyzan, Anna
dc.identifier.citationHöhn , A , Gampe , J , Lindahl-Jacobsen , R , Christensen , K & Oksuyzan , A 2020 , ' Do men avoid seeking medical advice? A register-based analysis of gender-specific changes in primary healthcare use after first hospitalisation at ages 60+ in Denmark ' , Journal of Epidemiology and Community Health , vol. 74 , no. 7 .
dc.identifier.otherPURE: 275393875
dc.identifier.otherPURE UUID: 9f0dcb74-a181-489e-a16d-87cdd6755a01
dc.identifier.othercrossref: 10.1136/jech-2019-213435
dc.identifier.otherORCID: /0000-0002-7170-1205/work/98488313
dc.identifier.otherScopus: 85083696149
dc.descriptionThe work was supported by the US National Institute of Health (P01AG031719, R01AG026786, and 2P01AG031719), the VELUX Foundation and the Max Planck Society within the framework of the project “On the edge of societies: New vulnerable populations, emerging challenges for social policies and future demands for social innovation. The experience of the Baltic Sea States (2016-2021)”.en
dc.description.abstractBackground  It remains unclear whether women’s greater primary healthcare use reflects a lower treatment-seeking threshold or a health disadvantage. We address this question by studying primary healthcare use surrounding a major health shock. Methods  This cohort study utilises routinely-collected healthcare data covering the Danish population aged 60+ years between 1996 and 2011. Using a hurdle model, we investigate levels of non-use and levels of primary healthcare use before and after first inpatient hospitalisation for stroke, myocardial infarction (MI), chronic obstructive pulmonary disease (COPD) and gastrointestinal cancers (GIC). Results  Before hospitalisation, irrespective of cause, men were more likely than women to be non-users of primary healthcare (OR (95% CI): stroke 1.802 (1.731 to 1.872); MI 1.841 (1.760 to 1.922); COPD 2.160 (2.028 to 2.292); GIC 1.609 (1.525 to 1.693)). Men who were users had fewer primary healthcare contacts than women (proportional change (eβ) (95% CI): stroke 0.821 (0.806 to 0.836); MI 0.796 (0.778 to 0.814); COPD 0.855 (0.832 to 0.878); GIC 0.859 (0.838 to 0.881)). Following hospitalisation, changes in the probability of being a non-user (OR (95% CI): stroke 0.965 (0.879 to 1.052); MI 0.894 (0.789 to 0.999); COPD 0.755 (0.609 to 0.900); GIC 0.895 (0.801 to 0.988)) and levels of primary healthcare use (eβ (95% CI): stroke 1.113 (1.102 to 1.124); MI 1.112 (1.099 to 1.124); COPD 1.078 (1.063 to 1.093); GIC 1.097 (1.079 to 1.114)) were more pronounced among men. Gender differences widened after accounting for survival following hospitalisation. Conclusion  Women’s consistently higher levels of primary healthcare use are likely to be explained by a combination of a lower treatment-seeking threshold and a health disadvantage resulting from better survival in bad health.
dc.relation.ispartofJournal of Epidemiology and Community Healthen
dc.rightsCopyright © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
dc.subjectRA Public aspects of medicineen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleDo men avoid seeking medical advice? A register-based analysis of gender-specific changes in primary healthcare use after first hospitalisation at ages 60+ in Denmarken
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Geography & Sustainable Developmenten
dc.description.statusPeer revieweden

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